| NPI | 1609138098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: FL ME137025) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 183105) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME137025) | |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2018-07-26 |