| NPI | 1699046128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA MD451706) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MN 55802) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MN 106131) | |
| Enumeration Date | 2012-01-13 |
| Last Update Date | 2020-08-24 |