| NPI | 1518498765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 296113) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NY 296113) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2020-12-11 |