| NPI | 1154585966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NE 26305) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 293122) |
| 207R00000X Internal Medicine (Licence: PA MD466056) | |
| 207R00000X Internal Medicine (Licence: MI 4301113668) | |
| 207R00000X Internal Medicine (Licence: SD 10509) | |
| 207R00000X Internal Medicine (Licence: ND 15511) | |
| 207R00000X Internal Medicine (Licence: WI 7-320) | |
| 207R00000X Internal Medicine (Licence: IN 01080555A) | |
| 207R00000X Internal Medicine (Licence: MO 2016032739) | |
| Enumeration Date | 2008-07-11 |
| Last Update Date | 2024-09-17 |