NPI | 1508866633 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WV 15554) |
Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WV 15554) |
207P00000X Emergency Medicine (Licence: WV 15554) | |
Enumeration Date | 2005-07-29 |
Last Update Date | 2016-03-18 |