NPI | 1073925442 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME129685) |
Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: OH 35.150559) |
207R00000X Internal Medicine (Licence: FL ME129685) | |
207R00000X Internal Medicine (Licence: MN 74151) | |
Enumeration Date | 2014-05-20 |
Last Update Date | 2025-06-12 |