| NPI | 1124011457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: CT 029504) |
| Additional Taxonomies | 207RC0200X Internal Medicine Critical Care Medicine (Licence: CT 029504) |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2018-09-21 |