| NPI | 1902834633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WI 72679-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 45458) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 35081071) | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2021-11-23 |