| NPI | 1679577399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PR 13144) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 13144) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PR 13144) | |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2020-05-01 |