| NPI | 1679675953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME111379) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036110048) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA MT198254) | |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2018-10-21 |