| NPI | 1992791685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 35712) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: KY 35712) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: IN 01027862A) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IN 01027862A) | |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: IN 71002793B) | |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: KY 3005907) | |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2023-03-07 |