| NPI | 1295718419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 29076) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 29076) |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: AZ 29076) | |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2020-10-02 |