| NPI | 1700046950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 35133) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0116019989) |
| 207R00000X Internal Medicine (Licence: NE 26405) | |
| 207R00000X Internal Medicine (Licence: NJ 25MA08860600) | |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2018-05-22 |