| NPI | 1740210194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA MD.204017) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-086926) |
| 208M00000X Hospitalist (Licence: OH 35-086926) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX N2028) | |
| 207R00000X Internal Medicine (Licence: TX N2028) | |
| 207R00000X Internal Medicine (Licence: OH 35.086926) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2022-02-11 |