| NPI | 1760468177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX N8388) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WA 60181807) |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2018-06-21 |