| NPI | 1134570526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: MT 102821) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MT MED-PHYS-LIC-102821) |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: MT MED-PHYS-LIC-102821) | |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2024-03-29 |