| NPI | 1982010609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: SD 12658) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2014019453) |
| 207RC0200X Internal Medicine Critical Care Medicine (Licence: MO 2014019453) | |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: MO 2014019453) | |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: SD 12658) | |
| 208000000X Pediatrics (Licence: SD 12658) | |
| 208000000X Pediatrics (Licence: MO 2014019453) | |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2024-01-09 |