| NPI | 1851592075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: LA MD.201136) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA MD.201136) |
| 207RC0200X Internal Medicine Critical Care Medicine (Licence: TX N3533) | |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2013-03-26 |