| NPI | 1558624437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: WV 28277) |
| Additional Taxonomies | 207RP1001X Internal Medicine Pulmonary Disease (Licence: WV 28277) |
| 207R00000X Internal Medicine (Licence: WV 28277) | |
| Enumeration Date | 2012-06-16 |
| Last Update Date | 2020-04-21 |