| NPI | 1588079479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX T4413) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX T4413) |
| 207R00000X Internal Medicine (Licence: IL 125065761) | |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2022-02-04 |