| NPI | 1124104609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA 20182) |
| Additional Taxonomies | 207RC0200X Internal Medicine Critical Care Medicine (Licence: IA 20182) |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: IA 20182) | |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2009-08-11 |