| NPI | 1023459682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS14456) |
| Additional Taxonomies | 202K00000X (Licence: FL OS14456) |
| 207R00000X Internal Medicine (Licence: SC 83344) | |
| 207R00000X Internal Medicine (Licence: MI 5101022246) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: SC 83344) | |
| 208M00000X Hospitalist (Licence: SC 83344) | |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2023-03-20 |