| 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 |