| NPI | 1770967036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WI 72088) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301108025) |
| Enumeration Date | 2015-07-16 |
| Last Update Date | 2021-11-22 |