| NPI | 1336437946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 91301) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: ND 14236) |
| Enumeration Date | 2011-07-17 |
| Last Update Date | 2022-03-25 |