| NPI | 1487603361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME87777) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 053386) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME87777) | |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2021-04-28 |