| NPI | 1962453399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: LA MD.205748) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WI 47373) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL 105323) | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2012-12-04 |