| NPI | 1154535516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME131965) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OK 31710) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2018-12-12 |