| NPI | 1366004392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WI 74993-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 74993-20) |
| Enumeration Date | 2019-06-29 |
| Last Update Date | 2025-08-25 |