| NPI | 1134521669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 55943) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: KY 55943) |
| 207R00000X Internal Medicine (Licence: KY 55943) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: KY TP267) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY TP267) | |
| Enumeration Date | 2014-09-16 |
| Last Update Date | 2021-09-30 |