| NPI | 1588273577 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: RI MD19080)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD19080)  | 
| Enumeration Date | 2020-07-27 | 
| Last Update Date | 2023-11-30 |