| NPI | 1023637964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 326752) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME170941) |
| 207R00000X Internal Medicine (Licence: ME MD27434) | |
| Enumeration Date | 2020-04-10 |
| Last Update Date | 2026-05-26 |