Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | D85130 | MD |
NPI | 1144602277 |
---|---|
Provider Name | Ethan Goldstein |
First Address | Washington, DC 20010-3017 |
Second Address | Washington, DC 20010-3017 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2015 |
Last Update Date | 26/08/2019 |