| NPI | 1639256456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME109038) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME109038) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2024-08-05 |