| NPI | 1417939315 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 040066) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 040066) | 
| Enumeration Date | 2005-11-16 | 
| Last Update Date | 2011-10-03 |