| NPI | 1841611944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME161207) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME161207) |
| 207R00000X Internal Medicine (Licence: OH 129416) | |
| Enumeration Date | 2013-12-17 |
| Last Update Date | 2024-09-11 |