| NPI | 1871525543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: VA 0101230375) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101230375) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: VA 0101230375) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2014-11-21 |