NPI | 1508393513 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 65024) |
Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CT 65024) |
207RP1001X Internal Medicine, Pulmonary Disease (Licence: CT 65024) | |
Enumeration Date | 2017-05-22 |
Last Update Date | 2024-06-06 |