| NPI | 1558761890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MA 290558) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WI 84537) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WI 84537) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MA 290558) | |
| 207R00000X Internal Medicine (Licence: IL 125065720) | |
| Enumeration Date | 2014-08-22 |
| Last Update Date | 2026-07-10 |