| NPI | 1063905040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX U6068) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 44457) |
| 207R00000X Internal Medicine (Licence: NY 312040) | |
| 207R00000X Internal Medicine (Licence: PA md488241c) | |
| 207R00000X Internal Medicine (Licence: AZ 76106) | |
| 207R00000X Internal Medicine (Licence: FL ME171879) | |
| 207R00000X Internal Medicine (Licence: MO 2025010575) | |
| 208M00000X Hospitalist (Licence: NY 312040) | |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2025-06-25 |