| NPI | 1780904631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TN 54254) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 252647) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TN 54254) | |
| Enumeration Date | 2010-06-02 |
| Last Update Date | 2024-05-14 |