| NPI | 1417175068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01074851A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.157774) |
| 207R00000X Internal Medicine (Licence: MT MED-PHYS-LIC-80845) | |
| 207R00000X Internal Medicine (Licence: SC 86662) | |
| 207R00000X Internal Medicine (Licence: TN 55630) | |
| 207R00000X Internal Medicine (Licence: MO 2007022067) | |
| 207R00000X Internal Medicine (Licence: KY 45395) | |
| 207R00000X Internal Medicine (Licence: FL ME145480) | |
| 207R00000X Internal Medicine (Licence: WA MD61262190) | |
| 207R00000X Internal Medicine (Licence: MO 2004017468) | |
| 207R00000X Internal Medicine (Licence: WI 50607-020) | |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2023-02-21 |