| NPI | 1659682441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 268535) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NY 268535) |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2026-02-10 |