| NPI | 1710912399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WV 28054) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WV 28054) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: KY 25206) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WI 65883) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 25206) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2018-08-15 |