| NPI | 1972660850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME91769) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL Me91769) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2022-10-03 |