| NPI | 1972609022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: IL 036-068002) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036-068002) |
| 207RC0200X Internal Medicine Critical Care Medicine (Licence: IL 036-068002) | |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2008-03-12 |