| NPI | 1356778161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV DO2162) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 10504179-1204) |
| 207R00000X Internal Medicine (Licence: CO DR0057213) | |
| 207R00000X Internal Medicine (Licence: OR DO187636) | |
| 207R00000X Internal Medicine (Licence: AZ 008320) | |
| 207R00000X Internal Medicine (Licence: OK 7134) | |
| 207R00000X Internal Medicine (Licence: SD 10908) | |
| 207R00000X Internal Medicine (Licence: ID OC-0024) | |
| Enumeration Date | 2013-10-11 |
| Last Update Date | 2025-01-27 |