| NPI | 1528546678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MN 79450) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 8375) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MN 79450) | |
| Enumeration Date | 2018-07-31 |
| Last Update Date | 2025-07-30 |