| NPI | 1407142870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA OS016265) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT013954) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2016-03-07 |