| NPI | 1699966689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD157489) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01095251A) |
| 207R00000X Internal Medicine (Licence: KY C3453) | |
| 207R00000X Internal Medicine (Licence: MO 2025003432) | |
| 207R00000X Internal Medicine (Licence: WA MD60152937) | |
| 207R00000X Internal Medicine (Licence: AZ 75436) | |
| 207R00000X Internal Medicine (Licence: GA 102314) | |
| 207R00000X Internal Medicine (Licence: IL 36172778) | |
| 207R00000X Internal Medicine (Licence: MS 34326) | |
| 207R00000X Internal Medicine (Licence: OH 35C.002018) | |
| 207R00000X Internal Medicine (Licence: AL 49890) | |
| 207R00000X Internal Medicine (Licence: TN 72878) | |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2025-08-27 |