| NPI | 1659355980 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA G079755)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G079755)  | 
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA G079755)  | |
| Enumeration Date | 2005-11-30 | 
| Last Update Date | 2011-09-29 |