| NPI | 1508233172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME 122568) |
| Additional Taxonomies | 202K00000X Phlebology (Licence: MD D0103372) |
| 207R00000X Internal Medicine (Licence: AL 38284) | |
| 208M00000X Hospitalist (Licence: LA 312436) | |
| Enumeration Date | 2015-08-30 |
| Last Update Date | 2026-01-06 |