| NPI | 1104246081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 310403) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101021259) |
| 207R00000X Internal Medicine (Licence: NY 310403) | |
| Enumeration Date | 2014-04-18 |
| Last Update Date | 2021-12-28 |