| NPI | 1770554123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: PA MD053484L) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD053484L) |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2007-10-17 |