| NPI | 1790895035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME75485) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NE FL-ME75485-A) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2017-02-20 |