| NPI | 1639171812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: MA 39369) |
| Additional Taxonomies | 207RP1001X Internal Medicine Pulmonary Disease (Licence: MA 39369) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2007-07-08 |