| NPI | 1982093720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME143095) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AZ 51825) |
| Enumeration Date | 2015-01-16 |
| Last Update Date | 2020-06-02 |