| NPI | 1992479414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NE TEP9056) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME175757) |
| Enumeration Date | 2021-08-07 |
| Last Update Date | 2025-08-21 |