| NPI | 1497814297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PR 10222) |
| Additional Taxonomies | 208600000X Surgery (Licence: PR 10222) |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: PR 10222) | |
| 2085R0001X (Licence: PR 10222) | |
| 207R00000X Internal Medicine (Licence: FL ME 71214) | |
| 207R00000X Internal Medicine (Licence: TX L1586) | |
| 207R00000X Internal Medicine (Licence: NY 191192) | |
| 208D00000X General Practice (Licence: PR 10222) | |
| 207R00000X Internal Medicine (Licence: PR 10222) | |
| 261QP2300X Clinic/Center, Primary Care (Licence: PR 10222) | |
| 208M00000X Hospitalist (Licence: TX L1586) | |
| 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: PR 10222) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PR 10222) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: PR 10222) | |
| Enumeration Date | 2006-12-07 |
| Last Update Date | 2026-02-09 |