| NPI | 1912192592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME106790) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME106790) |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2017-07-07 |