| NPI | 1689196776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PA MT220875) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.070517) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA MT220875) | |
| Enumeration Date | 2017-07-11 |
| Last Update Date | 2021-03-03 |