| NPI | 1558717835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME142810) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME142810) |
| 207R00000X Internal Medicine (Licence: AL MD.38306) | |
| Enumeration Date | 2016-05-05 |
| Last Update Date | 2019-12-30 |