| NPI | 1063832590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 296674) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 63798) |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2023-12-20 |