| NPI | 1891932596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 265041) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 265041) |
| Enumeration Date | 2009-01-16 |
| Last Update Date | 2022-07-21 |