| NPI | 1215132949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: RI MD14813) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2010024512) |
| 208M00000X Hospitalist (Licence: IL 036128606) | |
| 207Q00000X Family Medicine (Licence: CT 52895) | |
| 207Q00000X Family Medicine (Licence: IL 036128606) | |
| 208M00000X Hospitalist (Licence: CT 52895) | |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2026-05-29 |