| NPI | 1780681445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WI 54662) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: SC 22748) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2021-12-03 |