| NPI | 1215194337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 87954) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD036869) |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2025-05-19 |