| NPI | 1760760474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ME 20249) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 62389) |
| 207R00000X Internal Medicine (Licence: NY 269905-1) | |
| 207R00000X Internal Medicine (Licence: WA MD.61472437) | |
| 207R00000X Internal Medicine (Licence: IA MD-42960) | |
| 207R00000X Internal Medicine (Licence: MI 4301112613) | |
| 207R00000X Internal Medicine (Licence: WI 407-320) | |
| 207R00000X Internal Medicine (Licence: SD 13065) | |
| 207R00000X Internal Medicine (Licence: CO CDR.0001479) | |
| 207R00000X Internal Medicine (Licence: UT 13159316-1205) | |
| Enumeration Date | 2011-07-29 |
| Last Update Date | 2023-08-01 |