| NPI | 1720413123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A136204) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: ME MD19844) |
| Enumeration Date | 2013-09-05 |
| Last Update Date | 2015-10-12 |