| NPI | 1922560770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NC 2023-02542) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2023-02542) |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2025-09-17 |