| NPI | 1164750170 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A117693)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 263761)  | 
| 207R00000X Internal Medicine (Licence: CA A117693)  | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA A117693)  | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 263761)  | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 263761)  | |
| Enumeration Date | 2009-12-02 | 
| Last Update Date | 2018-07-17 |