| NPI | 1760731962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 74880) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: ME EL141008) |
| 208M00000X Hospitalist (Licence: NH 17040) | |
| Enumeration Date | 2012-09-04 |
| Last Update Date | 2020-10-16 |