| NPI | 1205978434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 34676) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CT 17941) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 131631) | |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2013-10-08 |