| NPI | 1073193835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 95974) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 12667) |
| Enumeration Date | 2021-04-14 |
| Last Update Date | 2026-08-03 |