| NPI | 1336500461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: ND PT20426) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS14955) |
| 208D00000X General Practice (Licence: FL OS14955) | |
| 207L00000X Anesthesiology (Licence: FL 00000000) | |
| Enumeration Date | 2016-03-17 |
| Last Update Date | 2024-04-08 |