| NPI | 1568676245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: ND 16222) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 23190) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX P3132) | |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2020-01-06 |