| NPI | 1457397218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME69028) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME0069028) |
| 174400000X Specialist (Licence: FL ME69028) | |
| 207R00000X Internal Medicine (Licence: FL ME69028) | |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2021-03-18 |