| NPI | 1063074094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 125.075168) |
| Additional Taxonomies | 207RC0200X Internal Medicine Critical Care Medicine (Licence: IL 036.159353) |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: IL 036.159353) | |
| Enumeration Date | 2019-06-29 |
| Last Update Date | 2022-05-21 |