| NPI | 1396416541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 337870) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NY P110750) |
| Enumeration Date | 2021-09-27 |
| Last Update Date | 2025-07-02 |