| NPI | 1821351560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MA 1027454) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WI 63682) |
| 208M00000X Hospitalist (Licence: FL ME147517) | |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2026-07-06 |