| NPI | 1205161320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 258953) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101246234) |
| 207R00000X Internal Medicine (Licence: NY 258953) | |
| Enumeration Date | 2009-10-07 |
| Last Update Date | 2025-07-03 |