| NPI | 1013029651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MA 47576) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: MA 47576) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2014-05-14 |