| NPI | 1003360041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 281159) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NY 281159-1) |
| Enumeration Date | 2016-08-08 |
| Last Update Date | 2025-03-05 |