| NPI | 1194748657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MN 47415) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 47415) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MN 47415) | |
| 208000000X Pediatrics (Licence: MN 47415) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2020-09-28 |