| NPI | 1629465059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: VA 0102206663) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 3670) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: VA 0102206663) | |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2021-06-23 |