| NPI | 1790042513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME132154) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME132154) |
| 207R00000X Internal Medicine (Licence: GA 84110) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 84110) | |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2022-09-21 |