| NPI | 1093715658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 17030) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.052781) |
| 207R00000X Internal Medicine (Licence: CO DR.0069828) | |
| 207R00000X Internal Medicine (Licence: HI MD-23143) | |
| 207R00000X Internal Medicine (Licence: OR MD213420) | |
| 207R00000X Internal Medicine (Licence: IL 036.157488) | |
| 207R00000X Internal Medicine (Licence: FL ME148147) | |
| 207R00000X Internal Medicine (Licence: TX AM00196) | |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2023-10-10 |