| NPI | 1780017988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 125.063566) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MD D0099611) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MD D0099611) | |
| Enumeration Date | 2013-08-12 |
| Last Update Date | 2024-08-09 |