| NPI | 1962607515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX M6801) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP1-0016939) |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2012-07-31 |