| NPI | 1619151503 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NH 24724) | 
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MA 269266) | 
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CT 53403) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WA 60217234) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CT 53403) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MA 269266) | |
| Enumeration Date | 2007-12-27 | 
| Last Update Date | 2023-09-05 |