| NPI | 1023496536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MT208959) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME156983) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: AL 42504) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME156983) | |
| Enumeration Date | 2015-05-16 |
| Last Update Date | 2022-08-10 |