| NPI | 1003893702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IA 29024) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 29024) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: IA 29024) | |
| Enumeration Date | 2005-12-23 |
| Last Update Date | 2007-12-04 |