| NPI | 1760619563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME132166) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA md205729) |
| 207R00000X Internal Medicine (Licence: MS 24008) | |
| 208M00000X Hospitalist (Licence: LA 205729) | |
| 208M00000X Hospitalist (Licence: FL ME132166) | |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2021-07-19 |