| NPI | 1972064129 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OR MD224633) | 
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: KS 94-11679) | 
| 207RI0200X Internal Medicine, Infectious Disease (Licence: UT 12751742-1205) | |
| Enumeration Date | 2019-03-29 | 
| Last Update Date | 2025-08-11 |