| NPI | 1366556292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 79703) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: PA MD436406) |
| 207R00000X Internal Medicine (Licence: MD D0066548) | |
| 207R00000X Internal Medicine (Licence: PA MD436406) | |
| 207R00000X Internal Medicine (Licence: OH 35-086618) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2026-03-24 |