| NPI | 1013917160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: FL MR77399) |
| Additional Taxonomies | 207RP1001X Internal Medicine Pulmonary Disease (Licence: FL ME77399) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2021-04-01 |