| NPI | 1588843015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA OS015241) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NJ 25MB07397600) |
| Enumeration Date | 2007-11-01 |
| Last Update Date | 2020-05-28 |