| NPI | 1467979344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OR MD190619) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MO 100534) |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2021-01-04 |