| NPI | 1023278017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MD D70492) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: DC md037282) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: VA 0101253148) | |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2025-10-13 |