| NPI | 1639606874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME151930) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: VA 0101268868) |
| Enumeration Date | 2017-05-18 |
| Last Update Date | 2024-02-06 |