| NPI | 1275896888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 1026953) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MI 4301100451) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MI 4301100451) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MA 1026953) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MA 1026953) | |
| 207R00000X Internal Medicine (Licence: MI 4301100451) | |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2026-06-11 |