| NPI | 1710968664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MD D60558) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 223892) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2022-03-08 |