| NPI | 1710240403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 79726) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 2306) |
| 207R00000X Internal Medicine (Licence: MI 4301108064) | |
| 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: MI 4301108064) | |
| 207R00000X Internal Medicine (Licence: PA MT202650) | |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2025-04-27 |