| NPI | 1982287967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX W3580) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX W3580) |
| 207R00000X Internal Medicine (Licence: NM MD2024-0587) | |
| Enumeration Date | 2021-04-28 |
| Last Update Date | 2026-07-02 |