| NPI | 1588001523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: HI MD-20778) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 61459) |
| 207R00000X Internal Medicine (Licence: PA MD455117) | |
| 207R00000X Internal Medicine (Licence: TN MD0000054556) | |
| 207R00000X Internal Medicine (Licence: WA MD60647491) | |
| Enumeration Date | 2013-05-31 |
| Last Update Date | 2021-06-30 |