| NPI | 1720462021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 72008) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 294638) |
| 208M00000X Hospitalist (Licence: NY 294638) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-07-16 |
| Last Update Date | 2023-08-09 |