| NPI | 1790016160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME119501) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 17747) |
| Enumeration Date | 2010-01-24 |
| Last Update Date | 2025-03-07 |