| NPI | 1912347667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 268792) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-9844) |
| 207RC0200X Internal Medicine Critical Care Medicine (Licence: NH EL08684) | |
| 207RC0200X Internal Medicine Critical Care Medicine (Licence: NY 321736) | |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2023-03-29 |