| NPI | 1699336339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME163495) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD18325) |
| 207R00000X Internal Medicine (Licence: RI LP04788) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: RI MD18325) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: RI MD18325) | |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2023-07-21 |