| NPI | 1952892085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: RI MD18628) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 237716) |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2022-08-04 |