| NPI | 1356362792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME74870) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO CDR.0002580) |
| 207R00000X Internal Medicine (Licence: MN 63310) | |
| 207R00000X Internal Medicine (Licence: KS 04-41167) | |
| 207R00000X Internal Medicine (Licence: WI 66908) | |
| 207R00000X Internal Medicine (Licence: GA 44949) | |
| 207R00000X Internal Medicine (Licence: MO 2019008703) | |
| 207R00000X Internal Medicine (Licence: IN 01078179A) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2024-01-03 |