| NPI | 1568425932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME56889) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME56889) |
| 207P00000X Emergency Medicine (Licence: FL ME56889) | |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2021-04-20 |