| NPI | 1790808095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 252143) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD00047863) |
| 207R00000X Internal Medicine (Licence: CT 48232) | |
| 208M00000X Hospitalist (Licence: CT 048232) | |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2017-02-18 |