| NPI | 1528367349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101262258) |
| Additional Taxonomies | 207RC0200X Internal Medicine Critical Care Medicine (Licence: VA 0101262258) |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: VA 0101262258) | |
| Enumeration Date | 2011-03-18 |
| Last Update Date | 2019-10-04 |