| NPI | 1861790487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 261790) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MT MED-PHYS-LIC-130719) |
| 207RS0012X Internal Medicine, Sleep Medicine (Licence: NY 261790) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 261790) | |
| 171100000X Acupuncturist (Licence: NY 001711) | |
| Enumeration Date | 2011-03-06 |
| Last Update Date | 2025-10-31 |