| NPI | 1740207695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME120233) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-73625) |
| 208M00000X Hospitalist (Licence: OH 35.073625) | |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2021-03-30 |