| NPI | 1720200744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: WV 21056) |
| Additional Taxonomies | 207RP1001X Internal Medicine Pulmonary Disease (Licence: WV 21056) |
| 207RS0012X Internal Medicine Sleep Medicine (Licence: WV 21056) | |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2021-03-16 |