| NPI | 1982961934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME136221) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 285980) |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2020-10-14 |