| NPI | 1285987552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: GA 90273) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01075577A) |
| Enumeration Date | 2012-10-23 |
| Last Update Date | 2022-01-03 |