| NPI | 1124083258 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NM MD2008-0644) | 
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX p0102) | 
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 36388) | |
| Enumeration Date | 2006-04-20 | 
| Last Update Date | 2020-05-04 |