| NPI | 1821040353 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WV 31668) | 
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME43081) | 
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: IN 01088744A) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NC 2014-02018) | |
| Enumeration Date | 2006-05-16 | 
| Last Update Date | 2023-09-27 |