| NPI | 1902205552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ME MD20127) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NH 20011) |
| Enumeration Date | 2014-08-20 |
| Last Update Date | 2022-02-16 |