| NPI | 1912226275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME116415) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10037747) |
| Enumeration Date | 2010-05-26 |
| Last Update Date | 2017-05-01 |