| NPI | 1407203490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MA 295190) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MA 295190) |
| 207R00000X Internal Medicine (Licence: RI MD16985) | |
| 207R00000X Internal Medicine (Licence: RI LP03677) | |
| 207R00000X Internal Medicine (Licence: MA 295190) | |
| 208000000X Pediatrics (Licence: MA 295190) | |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2026-06-11 |