| NPI | 1114967411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 6827) |
| Additional Taxonomies | 207RC0200X Internal Medicine Critical Care Medicine (Licence: AZ 6827) |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: AZ 6827) | |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2007-07-09 |