| NPI | 1134536600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MA 281913) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CT 55740) |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2025-01-22 |