| NPI | 1659309789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA G71446) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G71446) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2018-12-05 |