| NPI | 1326014119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CT 78812) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: CT 78812) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NY 221499) | |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2024-08-29 |