| NPI | 1770870867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C175506) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 81973) |
| 207R00000X Internal Medicine (Licence: NC 2021-00287) | |
| 207R00000X Internal Medicine (Licence: UT 13032787-1205) | |
| 207R00000X Internal Medicine (Licence: TN 52870) | |
| 207R00000X Internal Medicine (Licence: SC MD38903) | |
| 208M00000X Hospitalist (Licence: UT 13032787-1205) | |
| 208M00000X Hospitalist (Licence: NC 2021-00287) | |
| 208M00000X Hospitalist (Licence: WI 1913) | |
| Enumeration Date | 2011-07-08 |
| Last Update Date | 2024-11-11 |