| NPI | 1528234374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: AZ 40933) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 241024) |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2008-12-08 |