| NPI | 1053612614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MA 246884) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 246884) |
| Enumeration Date | 2010-11-12 |
| Last Update Date | 2019-06-12 |