| NPI | 1447554654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301098175) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MI 4301098175) | |
| Enumeration Date | 2011-01-03 |
| Last Update Date | 2024-04-03 |