| NPI | 1003077934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 46647) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: KY 46647) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2021-04-20 |