| NPI | 1982850863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MN 51848) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 51848) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: ND pt12754) | |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2013-07-03 |