| NPI | 1295115608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MN 69374) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2018023740) |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2021-09-13 |