| NPI | 1609099969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA C128481) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: KY 42010) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA C128481) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 42010) | |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2017-09-06 |