| NPI | 1548503907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: PA MD460603) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.063687) |
| 207RC0200X Internal Medicine Critical Care Medicine (Licence: PA MD460603) | |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2019-06-12 |