| NPI | 1871790188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME174617) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NM MD2015-0539) |
| 2086S0129X (Licence: NM MD2015-0539) | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2025-10-03 |