| NPI | 1144514217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX Q9701) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX Q9701) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 128163) | |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2021-08-24 |