| NPI | 1972036630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 182) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA 390200000) |
| 208M00000X Hospitalist (Licence: WI 2701) | |
| Enumeration Date | 2017-04-09 |
| Last Update Date | 2023-07-06 |