| NPI | 1801264353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: AZ 72596) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301108352) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: KY 54830) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: AZ 72596) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 54830) | |
| Enumeration Date | 2015-09-14 |
| Last Update Date | 2025-01-20 |