| NPI | 1306062054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NH 14756) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NH 14756) |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: NH 14756) | |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2013-11-04 |