| NPI | 1750437653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD27191) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AK 5194) |
| 207R00000X Internal Medicine (Licence: MO 2001032139) | |
| 207R00000X Internal Medicine (Licence: HI MD11798) | |
| 207R00000X Internal Medicine (Licence: GA 048102) | |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2022-02-04 |