| NPI | 1467436519 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME155664)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 037342)  | 
| 207R00000X Internal Medicine (Licence: NJ 25MA10684700)  | |
| 208M00000X Hospitalist (Licence: CT 037342)  | |
| Enumeration Date | 2005-12-02 | 
| Last Update Date | 2023-06-19 |