| NPI | 1376104059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MA 1017742) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 1017742) |
| 207R00000X Internal Medicine (Licence: PA MT217604) | |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2026-02-11 |