| NPI | 1831552264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME139975) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 55620) |
| 207R00000X Internal Medicine (Licence: LA 335492) | |
| 208M00000X Hospitalist (Licence: LA 335492) | |
| Enumeration Date | 2016-04-02 |
| Last Update Date | 2024-08-07 |