| NPI | 1730174400 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME98202)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD419228)  | 
| 207R00000X Internal Medicine (Licence: FL ME98202)  | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME98202)  | |
| 207RS0012X Internal Medicine, Sleep Medicine (Licence: FL ME98202)  | |
| Enumeration Date | 2005-09-19 | 
| Last Update Date | 2013-09-19 |