NPI | 1124655097 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME172528) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 91155) |
207R00000X Internal Medicine (Licence: LA 335183) | |
Enumeration Date | 2020-03-23 |
Last Update Date | 2025-07-22 |