| NPI | 1760485056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 102119) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NY 102119) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2010-01-11 |