| NPI | 1467859769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 289757-1) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A150464) |
| 207R00000X Internal Medicine (Licence: CT 62054) | |
| 208M00000X Hospitalist (Licence: CT 62055) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-12-02 |
| Last Update Date | 2018-11-06 |