| NPI | 1699262527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: ID O-1900) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 8336) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: ID O-1900) | |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2025-08-06 |