| NPI | 1376030254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 232521445) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0102206326) |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2026-05-13 |