| NPI | 1386960979 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MD D77970) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD d0077970) | 
| Enumeration Date | 2010-04-08 | 
| Last Update Date | 2019-09-10 |