| NPI | 1700170792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: AL 42114) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV 18792) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NV 18792) | |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2022-10-20 |