| NPI | 1780828095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME118166) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD446234) |
| 207R00000X Internal Medicine (Licence: FL ME118166) | |
| Enumeration Date | 2009-04-30 |
| Last Update Date | 2015-02-05 |