| NPI | 1811258601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: UT 10655975-1204) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV SL0882) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: ID O-1137) | |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2022-12-12 |