| NPI | 1982920690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2016-00027) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 266141) |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2020-10-26 |