| NPI | 1639525058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME146164) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NY 300181) |
| Enumeration Date | 2016-05-05 |
| Last Update Date | 2020-08-12 |