| NPI | 1336589100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME156853) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 285243) |
| 207Q00000X Family Medicine (Licence: FL ME156853) | |
| 207Q00000X Family Medicine (Licence: CA A139180) | |
| 208M00000X Hospitalist (Licence: NY 285243) | |
| 208M00000X Hospitalist (Licence: CA A139180) | |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2025-04-15 |