| NPI | 1124438981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME156171) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME156171) |
| 207Q00000X Family Medicine (Licence: MI 4301115585) | |
| Enumeration Date | 2014-05-02 |
| Last Update Date | 2024-04-03 |