| NPI | 1356684872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME139338) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD463791) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA MD463791) | |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2023-04-19 |