| NPI | 1790761021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MN 21855) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MN 21855) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2007-07-08 |