| NPI | 1902845373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A38782) |
| Additional Taxonomies | 207RC0200X Internal Medicine Critical Care Medicine (Licence: CA A37882) |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: CA A38782) | |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2007-07-08 |