| NPI | 1619002888 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: VA 0101251644)  | 
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NJ 25MA077181)  | 
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME101167)  | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NJ 25MA07718100)  | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NC 2014-02066)  | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: AZ 47094)  | |
| 207R00000X Internal Medicine (Licence: NJ 25MA07718100)  | |
| Enumeration Date | 2007-02-21 | 
| Last Update Date | 2025-01-28 |