| NPI | 1629305784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC MD39270) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: SC MD39270) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: SC MD39270) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GU M-2396) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GU M-2396) | |
| Enumeration Date | 2009-11-11 |
| Last Update Date | 2023-09-19 |