| NPI | 1982085973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: NY 337074) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A171700) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2025-06-30 |