| NPI | 1780821744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 078602) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 078602) |
| 207R00000X Internal Medicine (Licence: NY 270619-1) | |
| Enumeration Date | 2009-01-13 |
| Last Update Date | 2018-07-17 |