| NPI | 1619266319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MI 4301503853) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301503853) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: MI 4301503853) | |
| 2471C1106X Radiologic Technologist, Cardiac-Interventional Technology (Licence: MI 4301503853) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MI 4301503853) | |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2023-09-21 |