| NPI | 1104225523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: PR 18861) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 18861) |
| 207RC0200X Internal Medicine Critical Care Medicine (Licence: PR 18861) | |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2023-07-16 |