| NPI | 1326335209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 49748) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: KY 49748) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: IL 036134940) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IL 036134940) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WV 29276) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35.130110) | |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2025-05-01 |