| NPI | 1548580368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 270640) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 54527) |
| 207R00000X Internal Medicine (Licence: NH 21872) | |
| 207R00000X Internal Medicine (Licence: WA MD60749731) | |
| 207R00000X Internal Medicine (Licence: CO DR.0056950) | |
| 207R00000X Internal Medicine (Licence: GA 74959) | |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2023-12-14 |