| NPI | 1821440066 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA DO-05326) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 02007685A) | 
| 207R00000X Internal Medicine (Licence: MN 73220) | |
| 207R00000X Internal Medicine (Licence: IL 036165589) | |
| 207R00000X Internal Medicine (Licence: WI 1865-321) | |
| 207R00000X Internal Medicine (Licence: OH 34C.000134) | |
| 207R00000X Internal Medicine (Licence: MI EMC0005157) | |
| 207R00000X Internal Medicine (Licence: MO 2024041979) | |
| Enumeration Date | 2016-07-12 | 
| Last Update Date | 2024-11-12 |