NPI | 1376065250 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C09195) |
Additional Taxonomies | 208M00000X Hospitalist (Licence: NY 021009) |
363A00000X Physician Assistant (Licence: NY 021009) | |
Enumeration Date | 2017-07-12 |
Last Update Date | 2024-02-05 |