| NPI | 1972943454 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME129597) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 006671) |
| 208M00000X Hospitalist (Licence: FL ME12598) | |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2024-01-02 |