| NPI | 1619177532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA A115446) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A115446) |
| 207R00000X Internal Medicine (Licence: NY 99999999999999999999) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A115446) | |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2017-09-28 |