| NPI | 1922010966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME102214) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA A836690) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 35090669) | |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2013-04-22 |