| NPI | 1427615558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 316411) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP04554) |
| 207R00000X Internal Medicine (Licence: NY 316411-01) | |
| Enumeration Date | 2019-05-23 |
| Last Update Date | 2022-07-14 |