| NPI | 1104079128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 261456) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25mb08486000) |
| 207R00000X Internal Medicine (Licence: TX n3151) | |
| 208M00000X Hospitalist (Licence: MA 261456) | |
| Enumeration Date | 2008-11-04 |
| Last Update Date | 2016-07-08 |