| NPI | 1104806322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 213101) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 213101-1) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2019-05-23 |