| NPI | 1457338485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WY 2947A) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WY 2947A) |
| 207R00000X Internal Medicine (Licence: WY 2947A) | |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2011-05-26 |