| NPI | 1164678280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX N9672) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301091721) |
| Enumeration Date | 2008-08-08 |
| Last Update Date | 2017-10-18 |