| NPI | 1952693079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5101022492) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NY 275948) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 63116) | |
| Enumeration Date | 2011-05-08 |
| Last Update Date | 2021-12-17 |