| NPI | 1609061191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA A121518) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT188668) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A121518) | |
| Enumeration Date | 2007-09-08 |
| Last Update Date | 2017-09-07 |