| NPI | 1285829994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 64669) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: KY 45686) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 45686) | |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2022-01-04 |