| NPI | 1114076452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MA 230977) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ME 017263) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NH 19057) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MA 230977) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NH 19057) | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2020-07-24 |