| NPI | 1982070306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME164737) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 296208) |
| 207R00000X Internal Medicine (Licence: CA 168159) | |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA 168159) | |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NY 296208) | |
| 208M00000X Hospitalist (Licence: CA 168159) | |
| 208M00000X Hospitalist (Licence: NY 296208) | |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2024-01-03 |