| NPI | 1861704868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NE 27322) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 6257) |
| 207R00000X Internal Medicine (Licence: NE 27322) | |
| Enumeration Date | 2010-07-07 |
| Last Update Date | 2019-01-23 |