| NPI | 1023223260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: GA 072650) |
| Additional Taxonomies | 207RP1001X Internal Medicine Pulmonary Disease (Licence: NC 2008-01380) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2020-08-19 |