| NPI | 1508399841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: UT 109570201205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 10957020-1205) |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2025-06-24 |