| NPI | 1548528565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: CT 62410) |
| Additional Taxonomies | 207RP1001X Internal Medicine Pulmonary Disease (Licence: CT 62410) |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2020-01-25 |