| NPI | 1902216583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: TX S5663) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME128101) |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2024-02-12 |