| NPI | 1003125485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 258769) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 258769-1) |
| Enumeration Date | 2010-10-01 |
| Last Update Date | 2017-07-21 |