| NPI | 1376047647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A179808) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: LA 343988) |
| 207R00000X Internal Medicine (Licence: NY 311681) | |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2026-02-10 |