| NPI | 1326333279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME141615) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME141615) |
| 208D00000X General Practice (Licence: MO 20140082616) | |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2021-01-25 |