| NPI | 1619289170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CT 67155) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.126544) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 35.126544) | |
| Enumeration Date | 2010-07-12 |
| Last Update Date | 2022-07-21 |