| NPI | 1861579302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 11922) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NH 11922) |
| 208M00000X Hospitalist (Licence: ME 016064) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2007-08-03 |