| NPI | 1871704221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME152827) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA MD434242) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PA MD434242) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: VA 0101272454) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL me152827) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2026-05-12 |