| NPI | 1760762819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME137887) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 58778) |
| 208M00000X Hospitalist (Licence: MN 58778) | |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2020-10-07 |