| NPI | 1811122666 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: AZ 43503) | 
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MN 59011) | 
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: AZ 43503) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MN 59011) | |
| Enumeration Date | 2009-05-22 | 
| Last Update Date | 2020-09-09 |