| NPI | 1922418318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: KY 50288) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WA md.md.61065089) |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2020-08-05 |