| NPI | 1578763611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WI 56210) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MN 53440) |
| 207R00000X Internal Medicine (Licence: MI 4301089634) | |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2021-11-30 |