| NPI | 1629718531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 344352) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA 1629718531) |
| 207R00000X Internal Medicine (Licence: NY 344352) | |
| Enumeration Date | 2022-03-30 |
| Last Update Date | 2026-06-05 |