| NPI | 1790026888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: VA 0101256707) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101256707) |
| Enumeration Date | 2013-03-14 |
| Last Update Date | 2024-09-12 |