| NPI | 1629262944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WV 2338) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WV 2338) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WV 2338) | |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2020-11-20 |