| NPI | 1679728695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME140525) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35093303) |
| 207R00000X Internal Medicine (Licence: FL ME140525) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-11-18 |
| Last Update Date | 2020-09-21 |