| NPI | 1871758953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NC 2016-01656) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.096985) |
| 208000000X Pediatrics (Licence: OH 35.096985) | |
| 208000000X Pediatrics (Licence: NY 259031) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NY 259031) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: OH 35.096985) | |
| 207R00000X Internal Medicine (Licence: NY 259031) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 35.096985) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 259031) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NC 2016-01656) | |
| Enumeration Date | 2008-07-28 |
| Last Update Date | 2019-08-05 |