| NPI | 1720478449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101262236) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: VA 0101262236) |
| Enumeration Date | 2015-02-03 |
| Last Update Date | 2021-10-12 |