| NPI | 1023217502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME105378) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD.70036493) |
| 207Q00000X Family Medicine (Licence: FL ME105378) | |
| 207Q00000X Family Medicine (Licence: MI 4301515679) | |
| 208M00000X Hospitalist (Licence: CA C157968) | |
| 207Q00000X Family Medicine (Licence: CA C157968) | |
| 207Q00000X Family Medicine (Licence: TX W2081) | |
| 207Q00000X Family Medicine (Licence: CO DR.0076489) | |
| 207Q00000X Family Medicine (Licence: IN 01098284A) | |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2025-11-07 |