| NPI | 1194217828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PA MT223139) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP04292) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA MT223139) | |
| Enumeration Date | 2018-05-30 |
| Last Update Date | 2021-06-18 |