| NPI | 1285826792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ME 018017) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: ME 018017) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: KY 41297) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY TP501) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: ME 018017) | |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2021-05-05 |