| NPI | 1871751164 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ME 018868) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 231869) | 
| 207R00000X Internal Medicine (Licence: ME 018868) | |
| Enumeration Date | 2008-05-23 | 
| Last Update Date | 2011-09-07 |