| NPI | 1790866333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 248397-1) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101058482) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: VA 0101058482) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: VA 0101058482) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 248397-1) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 248397) | |
| 207R00000X Internal Medicine (Licence: NY 248397) | |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2024-03-19 |