| NPI | 1861807489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: KY 53751) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 27645) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WV 27645) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WV 27645) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 53751) | |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2024-03-06 |