| NPI | 1053674994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 283101) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 283101-1) |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2022-02-16 |