| NPI | 1962523381 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: ND 10454)  | 
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 054461)  | 
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 054461)  | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: GA 054461)  | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: KY 52641)  | |
| 207R00000X Internal Medicine (Licence: ND 10454)  | |
| 207R00000X Internal Medicine (Licence: GA 054461)  | |
| Enumeration Date | 2007-04-03 | 
| Last Update Date | 2020-12-16 |