NPI | 1164611075 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A43194) |
Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA A43194) |
207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A43194) | |
Enumeration Date | 2007-10-16 |
Last Update Date | 2012-10-08 |