| NPI | 1124093810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MO R6H05) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO R6H05) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MO R6H05) | |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2022-05-19 |