| NPI | 1386707651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: CA A99519) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2006002051) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2010-08-10 |