| NPI | 1396854824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA 38349) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD054201L) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: IA 38349) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IA 38349) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2009-12-01 |