| NPI | 1851087696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 345938-01) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD493495) |
| Enumeration Date | 2023-04-14 |
| Last Update Date | 2026-07-09 |