| NPI | 1053653089 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 82608) | 
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 82608) | 
| Enumeration Date | 2013-03-16 | 
| Last Update Date | 2020-02-10 |