| NPI | 1285787606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 256493) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 256493) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2023-07-22 |