| NPI | 1932561321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2023-00401) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NC 2023-00401) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NC 2023-00401) | |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2025-09-25 |