| NPI | 1174773519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 256604) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 11111111) |
| 207R00000X Internal Medicine (Licence: NY 256604) | |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2023-12-19 |