| NPI | 1770744989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 35270) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 334379) |
| 207R00000X Internal Medicine (Licence: GA 66752) | |
| 207R00000X Internal Medicine (Licence: TN 67897) | |
| 207R00000X Internal Medicine (Licence: MS 25734) | |
| 207R00000X Internal Medicine (Licence: NV 23114) | |
| 207R00000X Internal Medicine (Licence: HI 16816) | |
| 207R00000X Internal Medicine (Licence: WI 1796320) | |
| 207R00000X Internal Medicine (Licence: IL 036147581) | |
| 207R00000X Internal Medicine (Licence: SC 34002) | |
| 207R00000X Internal Medicine (Licence: AL 31509) | |
| 207R00000X Internal Medicine (Licence: OH 35C.000288) | |
| 208M00000X Hospitalist (Licence: MT 129782) | |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2025-07-15 |