| NPI | 1598294704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 305612) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP04122) |
| 207R00000X Internal Medicine (Licence: NY 305612) | |
| 363AM0700X Physician Assistant, Medical (Licence: NY 305612) | |
| Enumeration Date | 2017-06-09 |
| Last Update Date | 2023-07-22 |