| NPI | 1871531269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: CT 33716) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 033716) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CT 033716) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CT 033716) | |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2020-09-03 |