| NPI | 1619350402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MN 70137) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP03539) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MN 70137) | |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2025-04-08 |