| NPI | 1962062604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 333962) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT019334) |
| 207R00000X Internal Medicine (Licence: NY 333962) | |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2025-01-24 |