| NPI | 1225392368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: IL 036149054) |
| Additional Taxonomies | 207RC0200X Internal Medicine Critical Care Medicine (Licence: TX PENDING) |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: TX PENDING) | |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2022-02-08 |