| NPI | 1528269727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME131749) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2005024753) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2023-06-22 |