| NPI | 1700298452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX U0427) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.130825) |
| 207R00000X Internal Medicine (Licence: MI 4301105723) | |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2023-05-16 |