| NPI | 1407056187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: HI 4589) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA MT189861) |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2020-02-26 |