| NPI | 1700822822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: KY 43982) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TN MD23936) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WV 30857) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 43982) | |
| 207R00000X Internal Medicine (Licence: KY 43982) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WV 30857) | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2021-11-02 |