| NPI | 1912971318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2005019902) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MT MED-PHYS-LIC-102786) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MO 2005019902) | |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2022-02-25 |