| NPI | 1942467576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME112373) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 97357) |
| 207R00000X Internal Medicine (Licence: FL ME112373) | |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2023-12-29 |