| NPI | 1285014720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 211592) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MI 4301059538) |
| 207R00000X Internal Medicine (Licence: MI 4301059538) | |
| 207R00000X Internal Medicine (Licence: NY 211592) | |
| Enumeration Date | 2015-05-30 |
| Last Update Date | 2025-08-12 |