| NPI | 1063724425 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MN 56920) | 
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MN 56920) | 
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MN 106808) | |
| Enumeration Date | 2010-07-13 | 
| Last Update Date | 2020-08-14 |