| NPI | 1699919837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME125456) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 32615) |
| 207R00000X Internal Medicine (Licence: FL ME125456) | |
| 207R00000X Internal Medicine (Licence: VA 0101253623) | |
| Enumeration Date | 2009-04-30 |
| Last Update Date | 2022-07-18 |