| NPI | 1689013054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NC 2017-01885) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NC 2017-01885) |
| 208D00000X General Practice (Licence: VA 0101256785) | |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2024-03-05 |