| NPI | 1962189720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MI 4351056313) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MI 4351056313) |
| 207R00000X Internal Medicine (Licence: IL 125.082050) | |
| Enumeration Date | 2023-07-03 |
| Last Update Date | 2026-05-19 |