| NPI | 1750797262 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IN 01078460A)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 85653)  | 
| 207R00000X Internal Medicine (Licence: IA MD-48355)  | |
| 207R00000X Internal Medicine (Licence: LA 325169)  | |
| 207R00000X Internal Medicine (Licence: MT MED-PHYS-LIC-87561)  | |
| 207R00000X Internal Medicine (Licence: MI 4301105372)  | |
| 207R00000X Internal Medicine (Licence: TX T9671)  | |
| 207R00000X Internal Medicine (Licence: WA MD61262287)  | |
| 207R00000X Internal Medicine (Licence: IN 01078460A)  | |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: OH 35134230)  | |
| Enumeration Date | 2014-07-03 | 
| Last Update Date | 2023-06-05 |