| NPI | 1053751651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 75854) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 27996) |
| 207R00000X Internal Medicine (Licence: MA 256037) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TN 4065) | |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2024-04-04 |