| NPI | 1972123032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.150109CTR) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 75188) |
| 207R00000X Internal Medicine (Licence: NY 326433) | |
| 207R00000X Internal Medicine (Licence: IN 01092625A) | |
| 207R00000X Internal Medicine (Licence: MI 4301511194) | |
| 207R00000X Internal Medicine (Licence: CO DR.0072842) | |
| 207R00000X Internal Medicine (Licence: FL ME167168) | |
| 207R00000X Internal Medicine (Licence: UT 13849209-1205) | |
| 207R00000X Internal Medicine (Licence: CT 1.077089) | |
| 207R00000X Internal Medicine (Licence: LA 340908) | |
| 207R00000X Internal Medicine (Licence: AK 222917) | |
| 207R00000X Internal Medicine (Licence: AZ 73133) | |
| 207R00000X Internal Medicine (Licence: MS 33320) | |
| Enumeration Date | 2020-04-19 |
| Last Update Date | 2024-06-07 |