| NPI | 1013370568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME145182) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 67960) |
| 207R00000X Internal Medicine (Licence: OH 35.144623) | |
| 207R00000X Internal Medicine (Licence: AL 45918) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207R00000X Internal Medicine (Licence: IL 036167875) | |
| 207R00000X Internal Medicine (Licence: NC 2021-02940) | |
| 207R00000X Internal Medicine (Licence: TX t5434) | |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2024-01-19 |