| NPI | 1902054414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME144157) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL me144157) |
| Enumeration Date | 2008-09-09 |
| Last Update Date | 2025-04-18 |