| NPI | 1891030268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: SC 85774) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101259016) |
| 207R00000X Internal Medicine (Licence: MD D0084520) | |
| Enumeration Date | 2012-12-11 |
| Last Update Date | 2024-07-10 |