| NPI | 1487620654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: NC 2006-00801) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 41555) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2012-12-05 |