| NPI | 1366678302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MD D72199) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: DC md037933) |
| Enumeration Date | 2009-06-04 |
| Last Update Date | 2011-11-14 |