| NPI | 1558656512 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VT 042-0014631)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL trn16217)  | 
| 208M00000X Hospitalist (Licence: NY 283131)  | |
| Enumeration Date | 2011-06-17 | 
| Last Update Date | 2020-01-23 |