| NPI | 1578570727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS4706) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC TL1019) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: SC TL1019) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL OS4706) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2011-07-21 |