| NPI | 1982805735 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NH 22707) | 
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA MD447939) | 
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PA MD447939) | |
| Enumeration Date | 2007-05-30 | 
| Last Update Date | 2022-07-29 |