| NPI | 1457647729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WV 29047) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 62350) |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2020-12-28 |