| NPI | 1487035945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2022-02055) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 320418-10) |
| 207R00000X Internal Medicine (Licence: GA 96209) | |
| 207R00000X Internal Medicine (Licence: AR E16022) | |
| 207R00000X Internal Medicine (Licence: IN 01088433A) | |
| 207R00000X Internal Medicine (Licence: MI 4301507669) | |
| 207R00000X Internal Medicine (Licence: OR MD185413) | |
| 207R00000X Internal Medicine (Licence: OH 35.147682) | |
| 207R00000X Internal Medicine (Licence: VA 0101279044) | |
| Enumeration Date | 2015-06-10 |
| Last Update Date | 2024-05-05 |