| NPI | 1629424692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 73620) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 73620) |
| 207R00000X Internal Medicine (Licence: FL ME140179) | |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2023-04-19 |