| NPI | 1174818520 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MA 270849) | 
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CT 56833) | 
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MA 270849) | |
| Enumeration Date | 2011-06-14 | 
| Last Update Date | 2025-05-13 |