| NPI | 1790976629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 238780) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 37400) |
| 208M00000X Hospitalist (Licence: MA 238780) | |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2020-04-27 |