| NPI | 1780624957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: VA 0102203007) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA OS 012251) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2021-02-15 |