| NPI | 1063875771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2019-01996) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101270344) |
| 207R00000X Internal Medicine (Licence: SC 84518) | |
| 207R00000X Internal Medicine (Licence: NY 299824) | |
| 207R00000X Internal Medicine (Licence: PA MD467814) | |
| 207R00000X Internal Medicine (Licence: UT 10992611-1205) | |
| 207R00000X Internal Medicine (Licence: WV 32482) | |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2023-09-21 |