| NPI | 1730484056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX N4599) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX N4599) |
| 207R00000X Internal Medicine (Licence: TX n4599) | |
| Enumeration Date | 2011-01-18 |
| Last Update Date | 2021-08-23 |