| NPI | 1639128556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A74946) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A74946) |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: CA A74946) | |
| 207RC0200X Internal Medicine Critical Care Medicine (Licence: CA A74946) | |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2014-10-27 |