| NPI | 1588861751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME104988) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT187880) |
| 207R00000X Internal Medicine (Licence: CA C56215) | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2015-10-22 |