| NPI | 1710089354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: HI MD-15278) |
| Additional Taxonomies | 207RC0200X Internal Medicine Critical Care Medicine (Licence: PA MT189824) |
| Enumeration Date | 2006-09-03 |
| Last Update Date | 2016-11-15 |