| NPI | 1881093052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME131598) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME131598) |
| 207R00000X Internal Medicine (Licence: OH 57.024098) | |
| Enumeration Date | 2014-08-13 |
| Last Update Date | 2024-02-05 |