| NPI | 1073877999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MI 5101019831) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: ND 15621) |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2022-04-14 |