| NPI | 1174902415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 298196) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 298196) |
| 208M00000X Hospitalist (Licence: NY 298196) | |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2023-06-28 |