| NPI | 1437413721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301101224) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IN 01076112A) |
| 261QU0200X Clinic/Center Urgent Care (Licence: MI 802446128) | |
| 207R00000X Internal Medicine (Licence: IN 01076112A) | |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2024-05-17 |