| NPI | 1205268588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2019010504) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 7073) |
| 207R00000X Internal Medicine (Licence: FL ME157164) | |
| 207R00000X Internal Medicine (Licence: OH 35.151493) | |
| 207R00000X Internal Medicine (Licence: MO 2019010504) | |
| 208M00000X Hospitalist (Licence: OH 35.151493) | |
| 208M00000X Hospitalist (Licence: CT 054673) | |
| 208M00000X Hospitalist (Licence: FL ME157164) | |
| Enumeration Date | 2013-08-08 |
| Last Update Date | 2025-05-15 |