| NPI | 1508833815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 149778) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: SC 32556) |
| Enumeration Date | 2006-03-06 |
| Last Update Date | 2011-01-31 |