| NPI | 1649414079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME113151) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME113151) |
| Enumeration Date | 2009-04-29 |
| Last Update Date | 2021-05-26 |