| NPI | 1558746404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: KY TP790) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME150817) |
| 207R00000X Internal Medicine (Licence: OH 35.125693) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME150817) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME150817) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY TP790) | |
| Enumeration Date | 2015-07-21 |
| Last Update Date | 2026-02-02 |