| NPI | 1780650382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: VT 032.0079938) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NH 13485) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2026-02-09 |