| NPI | 1235123316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N5123) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 81240) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: IN 01048311 A) | |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2022-04-04 |