| NPI | 1023469798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 0443297) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35C.002112) |
| 207R00000X Internal Medicine (Licence: WI 4334-320) | |
| 207R00000X Internal Medicine (Licence: GA 008368) | |
| 207R00000X Internal Medicine (Licence: MN 76698) | |
| 207R00000X Internal Medicine (Licence: NE CP729) | |
| 207R00000X Internal Medicine (Licence: IA MD-46166) | |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2024-12-20 |