| NPI | 1790124675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 285129) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 285129) |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2021-04-13 |