| NPI | 1992747869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: PA MD456351) |
| Additional Taxonomies | 207RC0200X Internal Medicine Critical Care Medicine (Licence: CA A106835) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2022-11-18 |