| NPI | 1760646780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MA 243092) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125054537) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MA 243092) | |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2013-05-22 |