| NPI | 1750086260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: IL 036.180803) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.081167) |
| Enumeration Date | 2023-04-03 |
| Last Update Date | 2026-07-03 |