| NPI | 1225332133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: KY 47833) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT192025) |
| 207RC0200X Internal Medicine Critical Care Medicine (Licence: KY 47833) | |
| Enumeration Date | 2011-01-06 |
| Last Update Date | 2018-05-31 |