| NPI | 1811252075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX P7098) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX P7098) |
| Enumeration Date | 2012-07-12 |
| Last Update Date | 2023-01-20 |