| NPI | 1730611542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101284003) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 72516) |
| 208M00000X Hospitalist (Licence: MO 2020025858) | |
| 207R00000X Internal Medicine (Licence: MO 2020025858) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: TX U0410) | |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2025-01-27 |