| NPI | 1104845734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036079704) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: IL 036079704) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IL 036079704) | |
| 207R00000X Internal Medicine (Licence: TX h2772) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX h2772) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX h2772) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2017-03-03 |