| NPI | 1063483113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 200001378) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NC 200001378) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2024-06-27 |