| NPI | 1366653891 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WI 69065)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2006029624)  | 
| Enumeration Date | 2007-05-25 | 
| Last Update Date | 2024-01-23 |