| NPI | 1356834477 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME167227) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD.MD.61262649) | 
| 207R00000X Internal Medicine (Licence: NY 313542) | |
| 208M00000X Hospitalist (Licence: NY 313542) | |
| Enumeration Date | 2018-06-13 | 
| Last Update Date | 2024-07-29 |