| NPI | 1861498602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 220490) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 220490-1) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: NY 220490) | |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2024-05-02 |