| NPI | 1932653375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME154349) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 28906) |
| Enumeration Date | 2016-08-13 |
| Last Update Date | 2023-11-30 |