| NPI | 1598114811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME140658) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 58700) |
| 207R00000X Internal Medicine (Licence: LA 343691) | |
| 208M00000X Hospitalist (Licence: FL ME140658) | |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2025-05-16 |