| NPI | 1386608255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 02005177A) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: ND 20080) |
| 207R00000X Internal Medicine (Licence: TN 2762) | |
| 207R00000X Internal Medicine (Licence: TX L6911) | |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2023-08-08 |