| NPI | 1649523713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 274920) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME131356) |
| Enumeration Date | 2012-10-26 |
| Last Update Date | 2019-07-24 |