| NPI | 1821436775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GU M-2714) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2017-00041) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GU MTL-2019-016) | |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2019-09-30 |