| NPI | 1134416019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01074886A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 99065016A) |
| 207R00000X Internal Medicine (Licence: WI 62598-20) | |
| 207R00000X Internal Medicine (Licence: IA MD-48086) | |
| 207R00000X Internal Medicine (Licence: MT Med-Phys-Lic-80876) | |
| 207R00000X Internal Medicine (Licence: MO 2019004689) | |
| 207R00000X Internal Medicine (Licence: TN 55772) | |
| 207R00000X Internal Medicine (Licence: OK 33695) | |
| 207R00000X Internal Medicine (Licence: SC 87030) | |
| 207R00000X Internal Medicine (Licence: TX T8856) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301098701) | |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2023-02-21 |