| NPI | 1255795621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: AK 187853) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 62524) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: AZ 58410) | |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2022-07-01 |