| NPI | 1831266956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: VA 0101238352) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NC 2017-00069) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: SC 39103) | |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2019-07-31 |