| NPI | 1396988523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA MD451104) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PA MD451104) |
| 207R00000X Internal Medicine (Licence: PA MD451104) | |
| Enumeration Date | 2009-04-17 |
| Last Update Date | 2019-09-20 |