| NPI | 1861735854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 301172) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301109378) |
| Enumeration Date | 2013-03-28 |
| Last Update Date | 2019-09-24 |