| NPI | 1750772901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: AZ 71457) |
| Additional Taxonomies | 207RC0200X Internal Medicine Critical Care Medicine (Licence: MD D0089065) |
| 208D00000X General Practice (Licence: NE 29455) | |
| Enumeration Date | 2015-02-10 |
| Last Update Date | 2024-03-18 |