| NPI | 1558756353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME140347) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2018-01790) |
| 207R00000X Internal Medicine (Licence: NC 209624) | |
| 208M00000X Hospitalist (Licence: NC 2018-01790) | |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2019-08-13 |