| NPI | 1619224623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: GA 83498) |
| Additional Taxonomies | 207RC0200X Internal Medicine Critical Care Medicine (Licence: NY 293058) |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: CT 61868) | |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2019-11-04 |