| NPI | 1952887192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 320220) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND RL15077) |
| Enumeration Date | 2018-07-11 |
| Last Update Date | 2024-04-30 |