| NPI | 1104935469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 065915) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 065915) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 065915) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WV 23151) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 65915) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WV 23151) | |
| 208000000X Pediatrics (Licence: GA 065915) | |
| 208000000X Pediatrics (Licence: WV 23151) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2019-11-12 |