| NPI | 1689850182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL 100147) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME100147) |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2015-07-13 |