| NPI | 1306846589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NC 2008-00611) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD055492L) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2015-11-30 |