| NPI | 1164779179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MD D86168) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD454568) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 87526) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MI 4301110466) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: AR E-15836) | |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2023-01-27 |