| NPI | 1760010664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ME MD28515) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ME MD28515) |
| 207R00000X Internal Medicine (Licence: NH 24237) | |
| Enumeration Date | 2020-03-28 |
| Last Update Date | 2024-09-04 |