| NPI | 1609595156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME172523) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4351049765) |
| Enumeration Date | 2022-08-26 |
| Last Update Date | 2025-04-17 |