| NPI | 1548780687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NC 2025-01200) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 68892) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2025-08-13 |