| NPI | 1902247604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NV 20474) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: IN 01086727A) |
| Enumeration Date | 2013-07-10 |
| Last Update Date | 2023-03-13 |