| NPI | 1568401784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME79022) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 68766) |
| 208M00000X Hospitalist (Licence: WI 68766) | |
| 208M00000X Hospitalist (Licence: FL ME79022) | |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2025-02-11 |