| NPI | 1083734123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 249349) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: VA 0101267619) |
| 207Q00000X Family Medicine (Licence: VA 0101267619) | |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2024-10-28 |