| NPI | 1154748069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0073890) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 45894) |
| 207R00000X Internal Medicine (Licence: OH 35C.002170) | |
| 207R00000X Internal Medicine (Licence: AZ 75933) | |
| 207R00000X Internal Medicine (Licence: CA A141796) | |
| 207R00000X Internal Medicine (Licence: NV 26880) | |
| 207R00000X Internal Medicine (Licence: TX V5434) | |
| 207R00000X Internal Medicine (Licence: WA 60763233) | |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2025-05-29 |