| NPI | 1235500653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME140551) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101267417) |
| 207R00000X Internal Medicine (Licence: KY 52444) | |
| 207R00000X Internal Medicine (Licence: PR 22113) | |
| 207R00000X Internal Medicine (Licence: TN 58251) | |
| 207R00000X Internal Medicine (Licence: GA 83533) | |
| 207R00000X Internal Medicine (Licence: NY 322247) | |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2023-06-22 |