| NPI | 1679926901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IA 49090) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: IA 49090) |
| 282N00000X General Acute Care Hospital | |
| Enumeration Date | 2016-07-21 |
| Last Update Date | 2024-03-12 |