NPI | 1619403680 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 64956) |
Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CT 64956) |
Enumeration Date | 2017-05-11 |
Last Update Date | 2021-06-28 |