| NPI | 1104884741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 234050) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME93393) |
| 207Q00000X Family Medicine (Licence: NY 234050) | |
| 207R00000X Internal Medicine (Licence: NY 234050) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2021-04-19 |