| NPI | 1104123165 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA C153206) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 270736) | 
| 208M00000X Hospitalist (Licence: NY 270736) | |
| 207R00000X Internal Medicine (Licence: CA C153295) | |
| Enumeration Date | 2011-02-26 | 
| Last Update Date | 2018-03-17 |