| NPI | 1861704850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX Q7079) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX Q7079) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2025-02-07 |