| NPI | 1174057699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 305727) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 305727) |
| 208M00000X Hospitalist (Licence: NY 305727) | |
| 207R00000X Internal Medicine (Licence: VT 042.0017846) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VT 042.0017846) | |
| 208M00000X Hospitalist (Licence: VT 042.0017846) | |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2025-12-19 |