| NPI | 1669634788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX P2255) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 24072) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX P2255) | |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2015-04-03 |