| NPI | 1952789760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NV DO2451) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV SL1164) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NV DO2451) | |
| Enumeration Date | 2015-05-12 |
| Last Update Date | 2022-10-14 |