| NPI | 1689080475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME151050) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME151050) |
| 208M00000X Hospitalist (Licence: NY 290359) | |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2022-07-27 |