| NPI | 1194746453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: VA 0109542065) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD071427L) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA MD071427L) | |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2011-07-25 |