| NPI | 1619222585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MA 264099) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 264099) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2019-04-23 |