| NPI | 1871563940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: PA MD045185E) |
| Additional Taxonomies | 207RC0200X Internal Medicine Critical Care Medicine (Licence: MD DD 43443) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2015-08-19 |