| NPI | 1821544115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME162767) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA10648300) |
| 207RH0000X Internal Medicine, Hematology (Licence: FL ME162767) | |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2025-04-11 |