| NPI | 1407255482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX V3149) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 0000000000) |
| Enumeration Date | 2014-08-15 |
| Last Update Date | 2025-08-05 |