| NPI | 1700235066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME153197) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NJ 25MA10655200) |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2021-12-10 |