| NPI | 1962415182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA C161252) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WI 39669) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WI 39669) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35.083506) | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2023-02-21 |