| NPI | 1154371078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX H4873) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX H4873) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2011-01-11 |