| NPI | 1891051678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME123402) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.125914) |
| 207R00000X Internal Medicine (Licence: FL 123402) | |
| 208M00000X Hospitalist (Licence: FL ME123402) | |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2022-02-09 |