| NPI | 1871756247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WV 24049) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY R1601) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WV 24049) | |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2022-04-15 |