NPI | 1740795756 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX T1612) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX T1612) |
207R00000X Internal Medicine (Licence: CA 20A15821) | |
207RC0200X Internal Medicine, Critical Care Medicine (Licence: NJ 25MB10608100) | |
Enumeration Date | 2017-12-13 |
Last Update Date | 2024-12-02 |