| NPI | 1063585164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME127377) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101237467) |
| 207P00000X Emergency Medicine (Licence: VA 0101237467) | |
| 207R00000X Internal Medicine (Licence: CA C55251) | |
| 207R00000X Internal Medicine (Licence: VA 0101237467) | |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: CA 61-19200) | |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: CA 61-19200) | |
| 208M00000X Hospitalist (Licence: MO 2017005144) | |
| 208M00000X Hospitalist (Licence: VA 0101237467) | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2025-06-20 |