| NPI | 1912113804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL OS13254) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS 9743) |
| 207R00000X Internal Medicine (Licence: FL OS13254) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL OS13254) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MI 5101017385) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2021-03-03 |