| NPI | 1740809268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD482131) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: PA MD482131) |
| 208D00000X General Practice (Licence: FL ME157170) | |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2024-01-11 |