| NPI | 1801154455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CT 63895) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 291249-1) |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2024-05-14 |