| NPI | 1205488665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 110710) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.074770) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX U2898) | |
| Enumeration Date | 2019-07-15 |
| Last Update Date | 2026-07-15 |