| NPI | 1639115090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WI 51772) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036109523) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WI 51772) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2011-06-30 |