| NPI | 1891089777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: IL 036147673) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2017-00174) |
| 207R00000X Internal Medicine (Licence: OR MD173303) | |
| 207R00000X Internal Medicine (Licence: NY 276557) | |
| 207R00000X Internal Medicine (Licence: CA 139206) | |
| 207R00000X Internal Medicine (Licence: NV 15931) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NC 2017-00174) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NV 15931) | |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2022-03-02 |