NPI | 1700269362 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 289501) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 289501) |
207Q00000X Family Medicine (Licence: ME LT18015) | |
207R00000X Internal Medicine (Licence: CT 62056) | |
Enumeration Date | 2015-07-01 |
Last Update Date | 2023-08-18 |