| NPI | 1780903971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 251716) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 91509) |
| 207R00000X Internal Medicine (Licence: AZ 72732) | |
| 207R00000X Internal Medicine (Licence: IL 036.168528) | |
| 207R00000X Internal Medicine (Licence: AL MD.48112) | |
| 207R00000X Internal Medicine (Licence: HI MD24268) | |
| 207R00000X Internal Medicine (Licence: OH 35C.001303) | |
| 207R00000X Internal Medicine (Licence: NC 2024-01822) | |
| 207R00000X Internal Medicine (Licence: FL ME166617) | |
| 207R00000X Internal Medicine (Licence: TN 70584) | |
| 207R00000X Internal Medicine (Licence: OR MD218918) | |
| 207R00000X Internal Medicine (Licence: GA 100333) | |
| 207R00000X Internal Medicine (Licence: TX U8885) | |
| 207R00000X Internal Medicine (Licence: CO DR.0072398) | |
| 207R00000X Internal Medicine (Licence: PA MD484408) | |
| Enumeration Date | 2010-05-27 |
| Last Update Date | 2026-05-26 |