| NPI | 1790751204 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME104951) | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME104951) | 
| Enumeration Date | 2006-02-24 | 
| Last Update Date | 2019-05-01 |