| NPI | 1598012957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: KY 60006) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AR E-10689) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 311403) | |
| Enumeration Date | 2012-08-04 |
| Last Update Date | 2025-01-13 |