| NPI | 1902200512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 288440) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 288440) |
| Enumeration Date | 2014-10-10 |
| Last Update Date | 2018-12-04 |