| NPI | 1790773844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: AZ 40862) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35083849A) |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: AZ 40862) | |
| 207R00000X Internal Medicine (Licence: AZ 40862) | |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2015-10-21 |