| NPI | 1639117120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 226708) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME101820) |
| 207R00000X Internal Medicine (Licence: OH 350582718S) | |
| 208M00000X Hospitalist (Licence: FL ME101820) | |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2017-08-16 |