| NPI | 1033531546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 278263) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME136078) |
| 207R00000X Internal Medicine (Licence: PA MD452988) | |
| 207R00000X Internal Medicine (Licence: AZ 63707) | |
| 208D00000X General Practice (Licence: FL ME136078) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-01-17 |
| Last Update Date | 2023-03-13 |