| NPI | 1205217908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: TX T7573) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101261654) |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: VA 0101261654) | |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: TX T7573) | |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2024-06-10 |