| NPI | 1508109034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MI 4301509355) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 86559) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TN 57403) | |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2024-01-25 |