| NPI | 1528282456 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CT 062072) | 
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA MD430505) | 
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME106728) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 338418) | |
| Enumeration Date | 2007-04-12 | 
| Last Update Date | 2025-09-25 |