| NPI | 1821086703 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME93004) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME93004) | 
| 208M00000X Hospitalist (Licence: MO 2011030110) | |
| 208M00000X Hospitalist (Licence: IN 01071925A) | |
| Enumeration Date | 2005-10-13 | 
| Last Update Date | 2023-11-13 |