| NPI | 1821674698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 103717) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OK 9507) |
| 207R00000X Internal Medicine (Licence: TX V6027) | |
| Enumeration Date | 2021-03-22 |
| Last Update Date | 2026-06-01 |