| NPI | 1417461633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 334525) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NY 334525) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL S620-000-86-097-0) | |
| Enumeration Date | 2017-11-27 |
| Last Update Date | 2025-07-29 |