| NPI | 1760647051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101248531) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 55344) |
| 208M00000X Hospitalist (Licence: NY 302570) | |
| Enumeration Date | 2008-07-25 |
| Last Update Date | 2024-06-12 |