| NPI | 1598935801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA MT192018) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125-048901) |
| 207R00000X Internal Medicine (Licence: PA MT192018) | |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2008-09-21 |