| NPI | 1053744367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: IN 01083022A) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WV 26406) |
| Enumeration Date | 2013-08-11 |
| Last Update Date | 2019-10-17 |