| NPI | 1669735577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME125450) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL34936) |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2015-10-05 |