| NPI | 1265443980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 240375-1) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 240375-1) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2013-04-08 |