| NPI | 1922365683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ME DO2587) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NY 265691) |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2026-04-27 |