| NPI | 1811930720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME45602) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME45602) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2019-01-23 |