| NPI | 1912136086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CT 78693) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI 14008) |
| 207R00000X Internal Medicine (Licence: MA 273654) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MA 273654) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: RI MD14008) | |
| 208M00000X Hospitalist (Licence: MA 273654) | |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2024-07-01 |