| NPI | 1245644376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CO 0058738) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: KS 04-44645) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KS 04-44645) | |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2023-04-21 |