| NPI | 1114554995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WV 36719) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WV 36719) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA MD495209) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PA MD495209) | |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2026-06-30 |