| NPI | 1659477685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G61070) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA G61070) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA G61070) | |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2012-11-09 |