| NPI | 1215258595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OR MD156334) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NM MD2024-1285) |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2025-04-22 |