| NPI | 1174508105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 289251) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 44390) |
| 207R00000X Internal Medicine (Licence: FL ME75799) | |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2023-11-11 |