| NPI | 1609074210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WA MD.60710718) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: ID M-15137) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: UT 9136402-1205) | |
| 207R00000X Internal Medicine (Licence: NV 12745) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NV 12745) | |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2026-09-03 |