| 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 |