| NPI | 1467512848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036-087927) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A-63955) |
| 207R00000X Internal Medicine (Licence: AZ 35678) | |
| 207R00000X Internal Medicine (Licence: FL ME-94403) | |
| 207R00000X Internal Medicine (Licence: LA 12031-R) | |
| 207R00000X Internal Medicine (Licence: RI MD-08480) | |
| 207R00000X Internal Medicine (Licence: MD D-45408) | |
| 207R00000X Internal Medicine (Licence: HI MD-8672) | |
| 207R00000X Internal Medicine (Licence: NM MD 2006-0539) | |
| 207P00000X Emergency Medicine (Licence: IL 036087927) | |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2010-05-17 |