| NPI | 1659532919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME142947) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 33823) |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2020-02-06 |