| NPI | 1386829679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101254880) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD FM4237942) |
| 207R00000X Internal Medicine (Licence: VA FM3900518) | |
| 207R00000X Internal Medicine (Licence: NY 265253) | |
| 207R00000X Internal Medicine (Licence: PA MD448694) | |
| 207R00000X Internal Medicine (Licence: MD M80945) | |
| 207R00000X Internal Medicine (Licence: MD D0076463) | |
| 207R00000X Internal Medicine (Licence: PA FM4310683) | |
| Enumeration Date | 2008-01-04 |
| Last Update Date | 2023-03-07 |