| NPI | 1679721393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME104488) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME104488) |
| 208M00000X Hospitalist (Licence: CO CDRH.0056925) | |
| Enumeration Date | 2008-09-06 |
| Last Update Date | 2023-04-20 |