| NPI | 1912059502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CT 69116) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 240057) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2022-10-05 |