| NPI | 1831129493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G-31689) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA G-31689) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2011-07-20 |