| NPI | 1922238088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX P2127) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP 10033952) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MO 2024032503) | |
| Enumeration Date | 2009-07-22 |
| Last Update Date | 2025-12-01 |