| NPI | 1871030486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME136402) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL #TRN24062) |
| 207R00000X Internal Medicine (Licence: FL ME136402) | |
| Enumeration Date | 2017-01-21 |
| Last Update Date | 2022-04-04 |