| NPI | 1760605190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME127395) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME127395) |
| 208M00000X Hospitalist (Licence: ME 017390) | |
| 207R00000X Internal Medicine (Licence: ME 017390) | |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2019-11-13 |