| NPI | 1225231541 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PR 16812) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 16812) | 
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PR 16812) | |
| Enumeration Date | 2007-06-06 | 
| Last Update Date | 2015-04-20 |