| NPI | 1952470080 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MA 151129) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: RI MD10120) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MA 151129) | |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2025-01-22 |