| NPI | 1619965522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: IA 22745) |
| Additional Taxonomies | 207RA0201X Internal Medicine Allergy & Immunology (Licence: IA 22745) |
| 207RC0200X Internal Medicine Critical Care Medicine (Licence: IA 22745) | |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2007-12-04 |