| NPI | 1912159104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0001873) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MD D0001873) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MD D0001873) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MD D0001873) | |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2008-10-21 |