| NPI | 1710318472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME126650) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01073756A) |
| 208M00000X Hospitalist (Licence: DC ME126650) | |
| Enumeration Date | 2013-12-06 |
| Last Update Date | 2021-10-21 |