| NPI | 1689989204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2014-01572) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 01572) |
| 207R00000X Internal Medicine (Licence: NY 003590-1) | |
| 207R00000X Internal Medicine (Licence: VA 0101250364) | |
| 207R00000X Internal Medicine (Licence: SC 85945) | |
| 208M00000X Hospitalist (Licence: VA 0101250364) | |
| Enumeration Date | 2010-08-09 |
| Last Update Date | 2024-06-27 |