| NPI | 1275576134 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WV 28023)  | 
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: LA 15793R)  | 
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: LA MD.15793R)  | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 84943)  | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MD D76509)  | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: AZ 34241)  | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NC 2012-00240)  | |
| Enumeration Date | 2006-06-14 | 
| Last Update Date | 2022-04-08 |