| NPI | 1023091873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: TX E3755) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX E3755) |
| Enumeration Date | 2005-11-25 |
| Last Update Date | 2013-05-07 |