| NPI | 1659318020 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 244711)  | 
| Additional Taxonomies | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: IL 036-108517)  | 
| 207R00000X Internal Medicine (Licence: NY 244711)  | |
| Enumeration Date | 2006-06-02 | 
| Last Update Date | 2021-05-07 |