| NPI | 1750713590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 284867) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NY 284867) |
| Enumeration Date | 2013-08-03 |
| Last Update Date | 2017-06-21 |