| NPI | 1710987292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME0062461) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 271760-1) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 271760-1) | |
| 207RS0012X Internal Medicine, Sleep Medicine (Licence: NY 271760-1) | |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: NY 271760-1) | |
| Enumeration Date | 2005-07-27 |
| Last Update Date | 2019-04-11 |