| NPI | 1780620096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WI 48138) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OR MD126279) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OR MD126279) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2021-01-14 |