| NPI | 1144634494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MA 270321) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 270321) |
| Enumeration Date | 2014-06-15 |
| Last Update Date | 2017-06-29 |