| NPI | 1710516760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 337368) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA1176220) |
| 207R00000X Internal Medicine (Licence: NY 337368) | |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2025-09-25 |