| NPI | 1790970697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MT 29510) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: ME MD25284) |
| Enumeration Date | 2007-09-13 |
| Last Update Date | 2022-01-19 |