| NPI | 1043779325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NV DO3911) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0102206478) |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2025-11-05 |