| NPI | 1053807222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MO 2025016079) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 327233) |
| Enumeration Date | 2018-07-10 |
| Last Update Date | 2025-06-23 |