| NPI | 1528378072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MT 49958) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD476250) |
| 207R00000X Internal Medicine (Licence: KY 55990) | |
| 207R00000X Internal Medicine (Licence: NJ 25ma08851700) | |
| 207R00000X Internal Medicine (Licence: UT 12346821-1205) | |
| 207R00000X Internal Medicine (Licence: KS 04-45947) | |
| 207R00000X Internal Medicine (Licence: ID M-15839) | |
| Enumeration Date | 2010-10-18 |
| Last Update Date | 2024-09-05 |