| NPI | 1912137639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME112530) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NE FL-ME112530-A) |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2017-07-07 |