| NPI | 1336363373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 242928) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 242928) |
| 208M00000X Hospitalist (Licence: NY 242928) | |
| 207R00000X Internal Medicine (Licence: WV 25354) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WV 25354) | |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2026-04-29 |