| NPI | 1598922874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 246486) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME178297) |
| 207R00000X Internal Medicine (Licence: CO DR.0076561) | |
| 207P00000X Emergency Medicine (Licence: NJ 25MA08623200) | |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2026-06-11 |