| NPI | 1053677641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 95085) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 47736) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: AZ 47736) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: AZ 47736) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 95085) | |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2023-09-12 |