| 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: CA 20A15821) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NJ 25MB10608100) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA OS025277C) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: IN 02008616A) | |
| 207R00000X Internal Medicine (Licence: TX T1612) | |
| Enumeration Date | 2017-12-13 |
| Last Update Date | 2026-02-15 |