| NPI | 1760421895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME50488) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME50488) |
| 208M00000X Hospitalist (Licence: NC 2018-00868) | |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2025-12-18 |