| NPI | 1497953707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 256030) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 256030) |
| 207RP1002X Internal Medicine, Physician Nutrition Specialist (Licence: NY 256030) | |
| Enumeration Date | 2007-07-07 |
| Last Update Date | 2025-12-11 |