| NPI | 1417210600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA A136919) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT202538) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A136919) | |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2020-11-25 |