| NPI | 1912951401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OK 26145) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 39310) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OK 26145) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2017-05-09 |