| NPI | 1417193871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 072100) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2011-01142) |
| Enumeration Date | 2009-01-06 |
| Last Update Date | 2015-12-14 |