| NPI | 1952411225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CO DR.0036616) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME138300) |
| 207R00000X Internal Medicine (Licence: VT 0420009448) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2019-12-12 |