| NPI | 1548341837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: NY 204980) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 204980) |
| 207R00000X Internal Medicine (Licence: CT 000432) | |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: CT 000432) | |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: CT 000432) | |
| 208M00000X Hospitalist (Licence: CT 000432) | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2019-07-16 |