| NPI | 1780840306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: VA 0101250550) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: VA 0101250550) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WV 23167) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WV 23167) | |
| Enumeration Date | 2008-08-03 |
| Last Update Date | 2011-08-31 |