| NPI | 1821336173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME158028) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 71347) |
| 207R00000X Internal Medicine (Licence: FL ME158028) | |
| 207R00000X Internal Medicine (Licence: NE 28372) | |
| Enumeration Date | 2013-01-22 |
| Last Update Date | 2022-09-12 |