| NPI | 1659425817 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 68271) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ND 9882) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2020-10-13 |