| NPI | 1942283015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A62501) |
| Additional Taxonomies | 207RC0200X Internal Medicine Critical Care Medicine (Licence: CA A62501) |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: CA A62501) | |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2021-08-16 |