| NPI | 1609262633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MA 277405) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 61741) |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2019-02-01 |