| NPI | 1588047567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: MS 30801) |
| Additional Taxonomies | 207RP1001X Internal Medicine Pulmonary Disease (Licence: TX S8672) |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2023-01-05 |