| NPI | 1508227083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: VA 7591) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0102205570) |
| Enumeration Date | 2016-03-11 |
| Last Update Date | 2025-02-03 |