| NPI | 1164482782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME79930) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME 79930) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME79930) | |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2010-10-22 |