| NPI | 1679134357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME159240) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT219216) |
| 207R00000X Internal Medicine (Licence: FL ME159240) | |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2025-04-23 |