| NPI | 1700107034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MA 269594) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 269594) |
| 207R00000X Internal Medicine (Licence: SC 85323) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NC 2020-04639) | |
| 208M00000X Hospitalist (Licence: NC 2020-04639) | |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2024-03-22 |