| NPI | 1790739720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: KY 49334) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE C1-0005395) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2021-06-08 |