| NPI | 1235367319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MA 265705) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: RI MD14061) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: RI MD14061) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MA 265705) | |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2021-06-30 |