| NPI | 1841302122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA g84851) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME140044) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA G84851) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35.136070) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2019-12-05 |