| NPI | 1902218597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 292465) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 56674) |
| 207R00000X Internal Medicine (Licence: NY 292465) | |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: CT 56674) | |
| 208M00000X Hospitalist (Licence: CT 56674) | |
| 208M00000X Hospitalist (Licence: ME MD28262) | |
| Enumeration Date | 2014-05-30 |
| Last Update Date | 2025-07-16 |