| NPI | 1124042684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WV 12922) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WV 12922) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2007-07-09 |