| NPI | 1912438987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 54155) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY R4614) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: KY 54155) | |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2023-05-25 |