| NPI | 1205035508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA MD427838) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: HI MD13248) |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2007-07-17 |