| NPI | 1871900720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: NY 310270-01) |
| Additional Taxonomies | 207RC0200X Internal Medicine Critical Care Medicine (Licence: PA MD473034) |
| Enumeration Date | 2014-07-11 |
| Last Update Date | 2021-08-03 |