| NPI | 1932632890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: FL OS18645) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO5494) |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2022-06-27 |