| NPI | 1083651962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX 45987) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: ND 10031) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2018-03-17 |