| NPI | 1861703555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NE 27697) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 27697) |
| 208M00000X Hospitalist (Licence: IA MD-45709) | |
| 208M00000X Hospitalist (Licence: FL ME114786) | |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2019-03-08 |