| NPI | 1902287840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME166073) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME166073) |
| 207R00000X Internal Medicine (Licence: OH 35.133234) | |
| 207R00000X Internal Medicine (Licence: CT 1.063933) | |
| 208M00000X Hospitalist (Licence: CT 1.063933) | |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2024-03-25 |