| NPI | 1700805389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: CA G074355) |
| Additional Taxonomies | 207RP1001X Internal Medicine Pulmonary Disease (Licence: CA G074355) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2007-07-08 |