| NPI | 1073508602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ME MD26608) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2003-00611) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: VA 0101239901) | |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2023-03-23 |