| NPI | 1629509567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME143445) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NE 33682) |
| 208M00000X Hospitalist (Licence: RI MD17558) | |
| 207R00000X Internal Medicine (Licence: FL ME143445) | |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2026-09-22 |