| NPI | 1962612234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: KY 45004) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 45004) |
| 207RC0200X Internal Medicine Critical Care Medicine (Licence: KY 45004) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2021-04-13 |