| NPI | 1063825511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MT MED-PHYS-LIC-131944) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 287688) |
| 208M00000X Hospitalist (Licence: FL ME137702) | |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2024-01-19 |