| NPI | 1295087005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101255566) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: VA 0101255566) |
| 208M00000X Hospitalist (Licence: IA MD-41555) | |
| 208M00000X Hospitalist (Licence: NM MD2013-0271) | |
| 207Q00000X Family Medicine (Licence: NM MD2013-0271) | |
| 207Q00000X Family Medicine (Licence: OH 35.121641) | |
| 207Q00000X Family Medicine (Licence: CA A123436) | |
| 207Q00000X Family Medicine (Licence: IA MD-41555) | |
| 207Q00000X Family Medicine (Licence: NJ 25MA09337100) | |
| 208M00000X Hospitalist (Licence: OH 35.121641) | |
| 208M00000X Hospitalist (Licence: CA A123436) | |
| 208M00000X Hospitalist (Licence: NJ 25MA09337100) | |
| Enumeration Date | 2012-10-04 |
| Last Update Date | 2025-03-19 |