| NPI | 1295037430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME125124) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 67053) |
| 207R00000X Internal Medicine (Licence: SC 85198) | |
| 207R00000X Internal Medicine (Licence: CT 57123) | |
| 207R00000X Internal Medicine (Licence: TX T8799) | |
| 207R00000X Internal Medicine (Licence: OH 35.144508) | |
| 207R00000X Internal Medicine (Licence: VA 101269800) | |
| 207R00000X Internal Medicine (Licence: NC 2020-03593) | |
| Enumeration Date | 2010-11-19 |
| Last Update Date | 2023-12-21 |