| NPI | 1639460454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NY 281042) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NY 281042) |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2023-11-27 |