| NPI | 1194965608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WY 12118A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WY TL5680) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WY 12118A) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WY TL5680) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WY 12118A) | |
| Enumeration Date | 2009-02-23 |
| Last Update Date | 2021-02-18 |