| NPI | 1760779748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME143197) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MI 4301098057) |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2021-06-21 |