| NPI | 1639520323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CT 64209) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY AT-1823194-0337) |
| Enumeration Date | 2016-06-24 |
| Last Update Date | 2019-09-18 |