| NPI | 1710187331 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MA 232254)  | 
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MA 232254)  | 
| Enumeration Date | 2007-07-22 | 
| Last Update Date | 2012-04-05 |