| NPI | 1700154648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CT 062988) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 062988) |
| 207R00000X Internal Medicine (Licence: FL ME111014) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CT 062988) | |
| Enumeration Date | 2011-12-07 |
| Last Update Date | 2019-06-12 |