| NPI | 1639564263 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME137136) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME137136) |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2022-11-08 |