| NPI | 1831623800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OS023528) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS20926) |
| 207R00000X Internal Medicine (Licence: SC 92576) | |
| 207R00000X Internal Medicine (Licence: CT 77564) | |
| 207R00000X Internal Medicine (Licence: MA 1019995) | |
| 207R00000X Internal Medicine (Licence: VA 0102208604) | |
| 207R00000X Internal Medicine (Licence: NY 295205) | |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2024-08-29 |