| NPI | 1649251661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20A7408) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OS-009459-L) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CA 20A7408) | |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: CA 20A7408) | |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: CA 20A7408) | |
| 208M00000X Hospitalist (Licence: PA OS-009459L) | |
| 208M00000X Hospitalist (Licence: CA 20A7048) | |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2023-03-07 |