| NPI | 1386686566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NV 12329) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV 12329) |
| 207Q00000X Family Medicine (Licence: NY applied) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2017-10-27 |