| NPI | 1740393677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX Q4478) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 106234) |
| 207R00000X Internal Medicine (Licence: VA 0101240352) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2024-07-03 |