| NPI | 1922064427 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D63305)  | 
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MD D0063305)  | 
| Enumeration Date | 2006-04-24 | 
| Last Update Date | 2010-12-13 |