| NPI | 1982066643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 95640) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 95640) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2023-06-05 |