| NPI | 1780617977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME89483) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME89483) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2014-07-15 |