| NPI | 1689023814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME162730) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME162730) |
| 207R00000X Internal Medicine (Licence: GA 82406) | |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2023-09-29 |