| NPI | 1760444814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 224764) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NY 224764) |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2023-10-31 |