| NPI | 1962030056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MA 1020520) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 32242101) |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2024-10-31 |