| NPI | 1962813428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV 27003) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: NY 306125) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WV 27003) | |
| 207RN0300X Internal Medicine, Nephrology (Licence: WV 27003) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 306125) | |
| Enumeration Date | 2014-05-17 |
| Last Update Date | 2026-05-04 |