| NPI | 1649377086 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 161931) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 161931) | 
| Enumeration Date | 2006-09-20 | 
| Last Update Date | 2025-09-11 |