| NPI | 1801230248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA C176277) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NJ 25MA09905400) |
| 207Q00000X Family Medicine (Licence: FL ME143622) | |
| Enumeration Date | 2013-04-27 |
| Last Update Date | 2025-10-23 |