| NPI | 1760566020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G67935) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA G67935) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA G67935) | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2007-07-09 |