NPI | 1417151820 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 064829) |
Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 064829) |
207R00000X Internal Medicine (Licence: GA 064829) | |
208000000X Pediatrics (Licence: GA 064829) | |
Enumeration Date | 2007-06-12 |
Last Update Date | 2015-12-04 |