| NPI | 1386910396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101274354) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: VA 0101274354) |
| Enumeration Date | 2012-03-24 |
| Last Update Date | 2022-04-12 |