| NPI | 1255357679 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX L4249) | 
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX L4249) | 
| Enumeration Date | 2006-07-15 | 
| Last Update Date | 2017-07-05 |