| NPI | 1962740183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME143340) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME143340) |
| 207R00000X Internal Medicine (Licence: VA 0101253722) | |
| 208M00000X Hospitalist (Licence: VA 0101253722) | |
| Enumeration Date | 2013-01-23 |
| Last Update Date | 2020-06-10 |