| NPI | 1639675010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME157701) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 69752) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2022-07-13 |