| NPI | 1942402243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 313104) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME 99491) |
| 207R00000X Internal Medicine (Licence: CT 044718) | |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2022-05-16 |