| NPI | 1912213133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME108057) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME108057) |
| Enumeration Date | 2010-08-25 |
| Last Update Date | 2025-01-13 |