| NPI | 1902248826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MT-205285) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: SC MD40922) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: SC MD40922) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: VA 0101269099) | |
| Enumeration Date | 2013-07-19 |
| Last Update Date | 2021-07-29 |