| NPI | 1093049678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 125056184) |
| Additional Taxonomies | 207RP1001X Internal Medicine Pulmonary Disease (Licence: FL ME120243) |
| 207RC0200X Internal Medicine Critical Care Medicine (Licence: IA MD-42580) | |
| Enumeration Date | 2009-09-29 |
| Last Update Date | 2019-10-22 |