| NPI | 1790876290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME54922) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A48842) |
| 207R00000X Internal Medicine (Licence: FL ME54922) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2016-11-21 |