| NPI | 1609816503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 04188R) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: LA 04188R) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2011-10-31 |