| NPI | 1700893658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: KY 19693) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 19693) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2011-06-24 |