| NPI | 1992332126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME183379) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME183379) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 79714) | |
| 207R00000X Internal Medicine (Licence: FL ME183379) | |
| 208M00000X Hospitalist (Licence: KY 57933) | |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2026-07-24 |