| NPI | 1578083770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA MT218822) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 271762) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2021-09-22 |