| NPI | 1306549704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 344801) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 110624) |
| 208M00000X Hospitalist (Licence: GA 110624) | |
| 207R00000X Internal Medicine (Licence: NY 344801) | |
| Enumeration Date | 2023-03-24 |
| Last Update Date | 2026-06-01 |