| NPI | 1649429515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MA 278446) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D74597) |
| 207R00000X Internal Medicine (Licence: GA 003103) | |
| 207R00000X Internal Medicine (Licence: MN 54256) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MA 278446) | |
| Enumeration Date | 2008-09-15 |
| Last Update Date | 2019-09-20 |