| 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 |