| NPI | 1548410095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036127222) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301092793) |
| 207R00000X Internal Medicine (Licence: NC 2015-01269) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NC 2015-01269) | |
| Enumeration Date | 2008-09-22 |
| Last Update Date | 2025-07-08 |