| NPI | 1982621777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME122100) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036111723) |
| 208M00000X Hospitalist (Licence: WI 64042) | |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2022-07-21 |