| NPI | 1720241342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: WI 85595-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 244731) |
| 207R00000X Internal Medicine (Licence: CT 67817) | |
| 207RB0002X Internal Medicine, Bariatric Medicine (Licence: CT 67817) | |
| 208M00000X Hospitalist (Licence: MA 244731) | |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2025-07-01 |