| NPI | 1740543453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME136347) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MA 262907) |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2018-11-07 |