| NPI | 1497041370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX Q3573) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD461229) |
| 207R00000X Internal Medicine (Licence: WI 64934) | |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: PA MD461229) | |
| 208M00000X Hospitalist (Licence: PA MD461229) | |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2021-02-06 |