| NPI | 1578608220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME122573) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA08169300) |
| 208M00000X Hospitalist (Licence: FL ME122573) | |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2023-05-31 |