| NPI | 1730163924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MO 102114) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: IL 036-101199) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IL 036-101199) | |
| 207R00000X Internal Medicine (Licence: MO 102114) | |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2017-03-14 |