| NPI | 1659374189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: AZ 33978) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: AZ 33978) |
| 207R00000X Internal Medicine (Licence: AZ 33978) | |
| Enumeration Date | 2005-05-30 |
| Last Update Date | 2007-07-08 |