| NPI | 1265872725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 287474) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD2017-0687) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: LA 322076) | |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2022-03-16 |