| NPI | 1851704076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME127698) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GU M-2239) |
| 207R00000X Internal Medicine (Licence: NV 23411) | |
| 207R00000X Internal Medicine (Licence: WY 17103C) | |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2024-09-05 |