| NPI | 1508867896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 40980) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: KS 05-31001) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 40980) | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2021-02-26 |