| NPI | 1073770426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD454952) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G136048) |
| 207R00000X Internal Medicine (Licence: FL ME123487) | |
| 207R00000X Internal Medicine (Licence: NH 17714) | |
| 207R00000X Internal Medicine (Licence: NC 2017-00689) | |
| 207R00000X Internal Medicine (Licence: TX R1987) | |
| 207R00000X Internal Medicine (Licence: CT 55845) | |
| 207R00000X Internal Medicine (Licence: NY 172534) | |
| 207R00000X Internal Medicine (Licence: IA MD43425) | |
| 207R00000X Internal Medicine (Licence: OH 128699) | |
| 207R00000X Internal Medicine (Licence: NJ 25MA09936500) | |
| 207R00000X Internal Medicine (Licence: IL 036138366) | |
| 207R00000X Internal Medicine (Licence: MT 58678) | |
| 207R00000X Internal Medicine (Licence: NY 172534-1) | |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2021-09-07 |