| NPI | 1003195215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2017039278) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2017039278) |
| 207R00000X Internal Medicine (Licence: NY 312485) | |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: MO 2017039278) | |
| 208M00000X Hospitalist (Licence: NY 312485) | |
| Enumeration Date | 2011-08-05 |
| Last Update Date | 2024-10-30 |