| NPI | 1952311920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME96187) |
| Additional Taxonomies | 207RS0010X Internal Medicine, Sports Medicine (Licence: FL ME96187) |
| 208M00000X Hospitalist (Licence: FL ME96187) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2016-08-26 |