| NPI | 1265850549 |
|---|---|
| Other Name | N/A N/A N/A |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0090574) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 28421) |
| 207R00000X Internal Medicine (Licence: WI 68570-20) | |
| 207R00000X Internal Medicine (Licence: AZ 55076) | |
| 207R00000X Internal Medicine (Licence: VA 0101271816) | |
| 207R00000X Internal Medicine (Licence: TN 57102) | |
| 207R00000X Internal Medicine (Licence: NM MD2018-0672) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TN 57102) | |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2025-01-22 |