| NPI | 1750945515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA MT227989) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 92711) |
| Enumeration Date | 2019-04-26 |
| Last Update Date | 2025-03-17 |