| NPI | 1063636082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME106456) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NY 242845) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2016-11-11 |