| NPI | 1932155330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: ND 10535) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35057292) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: ND 10535) | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2019-07-29 |