| NPI | 1861467532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME116358) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NH 8332) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2013-12-11 |