| NPI | 1003122441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX R9639) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: KY 48773) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 48773) | |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2023-02-01 |