| NPI | 1174567705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ID M-14178) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD15177) |
| 207R00000X Internal Medicine (Licence: FL ME114642) | |
| 207R00000X Internal Medicine (Licence: TX J9928) | |
| 207R00000X Internal Medicine (Licence: NC 2022-00266) | |
| 208M00000X Hospitalist (Licence: TX J9928) | |
| 208M00000X Hospitalist (Licence: FL ME114642) | |
| 208M00000X Hospitalist (Licence: NC 2022-00266) | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2024-11-12 |