| NPI | 1821351560 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 63682)  | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME147517)  | 
| Enumeration Date | 2012-06-18 | 
| Last Update Date | 2023-04-28 |