| NPI | 1730102963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NM 20020119) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM 20020119) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NM 2002-0119) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2014-03-26 |