| NPI | 1952744948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME180711) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME180711) |
| 207R00000X Internal Medicine (Licence: CA C185449) | |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2026-06-05 |