| NPI | 1265968853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL MD.37284) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 71832) |
| 207R00000X Internal Medicine (Licence: NC 2025-01549) | |
| 207R00000X Internal Medicine (Licence: MS 35953) | |
| 207R00000X Internal Medicine (Licence: LA 322642) | |
| 207R00000X Internal Medicine (Licence: GA 100611) | |
| 207R00000X Internal Medicine (Licence: IL 036170726) | |
| 207R00000X Internal Medicine (Licence: IN 01094155A) | |
| 207R00000X Internal Medicine (Licence: FL ME170252) | |
| 207R00000X Internal Medicine (Licence: SC 88600) | |
| 208M00000X Hospitalist (Licence: SC 88600) | |
| Enumeration Date | 2017-05-03 |
| Last Update Date | 2025-09-30 |