| NPI | 1518198274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 93946) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NM MD2025-0008) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WA MD61359707) | |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2025-04-21 |