| NPI | 1700191053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME107948) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME107948) |
| 207R00000X Internal Medicine (Licence: NE FL-ME107948-A) | |
| 208M00000X Hospitalist (Licence: NY 272573) | |
| Enumeration Date | 2010-08-11 |
| Last Update Date | 2022-07-21 |