| NPI | 1518306901 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MN 69075) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 268628) | 
| Enumeration Date | 2013-06-18 | 
| Last Update Date | 2024-01-16 |