| NPI | 1619974599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: AR E2644) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AR E2644) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: AR E6244) | |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2010-07-20 |