| NPI | 1376774646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: GA 68158) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA 437958) |
| 207RC0200X Internal Medicine Critical Care Medicine (Licence: GA 68158) | |
| Enumeration Date | 2009-08-04 |
| Last Update Date | 2019-10-07 |