NPI | 1467543686 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 174400000X Specialist (Licence: DC MD19909) |
Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: VA 0101048655) |
207RN0300X Internal Medicine, Nephrology (Licence: DC MD19909) | |
207RN0300X Internal Medicine, Nephrology (Licence: MD D0042936) | |
261QP2300X Clinic/Center, Primary Care (Licence: DC MD19909) | |
302R00000X Health Maintenance Organization (Licence: DC MD19909) | |
302R00000X Health Maintenance Organization (Licence: VA 0101048655) | |
305R00000X Preferred Provider Organization (Licence: VA 0101048655) | |
305R00000X Preferred Provider Organization (Licence: DC MD19909) | |
305R00000X Preferred Provider Organization (Licence: MD D0042936) | |
305S00000X Point of Service (Licence: DC MD19909) | |
Enumeration Date | 2006-09-27 |
Last Update Date | 2024-10-11 |