| NPI | 1700986676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: FL ME141731) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 38217) |
| 207RC0200X Internal Medicine Critical Care Medicine (Licence: WI 38217) | |
| 207RC0200X Internal Medicine Critical Care Medicine (Licence: NH 17274) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2023-04-19 |