| NPI | 1013534148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 336356) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 336356) |
| 208M00000X Hospitalist (Licence: CT 76725) | |
| Enumeration Date | 2020-07-06 |
| Last Update Date | 2025-05-06 |