| NPI | 1841853470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 317583) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IL 036163467) |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2023-03-27 |