| NPI | 1104276583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME161820) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125068984) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME161820) | |
| 208000000X Pediatrics (Licence: IL 125068984) | |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2023-05-25 |