| NPI | 1689453524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: MS 905839) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MS 905839) |
| Enumeration Date | 2023-09-28 |
| Last Update Date | 2023-09-28 |