| NPI | 1790135754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20A19528) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101022490) |
| 207R00000X Internal Medicine (Licence: NM A-2292-19) | |
| 207R00000X Internal Medicine (Licence: IA DO-05466) | |
| 207R00000X Internal Medicine (Licence: TN 3868) | |
| 207R00000X Internal Medicine (Licence: VA 0102207828) | |
| 208M00000X Hospitalist (Licence: MD H90545) | |
| 208M00000X Hospitalist (Licence: CA 20A19528) | |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2024-12-05 |