| NPI | 1114964749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 49023) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MA 49023) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MA 49023) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2016-09-06 |